Medicaid Breast Cancer Access to Treatment Act
Sponsored By: Representative Waters, Maxine [D-CA-43]
Introduced
Summary
Expand Medicaid coverage for certain people with breast or cervical cancer. It would create a defined eligibility pathway, add coverage for breast reconstruction after a medically necessary mastectomy, and update financing and cost-sharing rules, with changes taking effect one year after enactment.
Show full summary
- People diagnosed with qualifying breast or cervical cancers would become eligible for Medicaid through a newly defined pathway in Title XIX. The bill reorganizes statutory subparagraphs and cross references so those individuals can access the full range of Medicaid diagnosis and treatment services.
- People who have a medically necessary mastectomy would have explicit Medicaid coverage for breast reconstruction and related services. The change inserts reconstruction into the list of covered medical assistance, making it a clear, listed benefit.
- State Medicaid programs would see technical but important updates to federal matching fund references and cost-sharing rules. The bill changes references to the Federal Medical Assistance Percentage (FMAP), alters cost-sharing language, and updates alternative cost-sharing provisions so these beneficiaries are included. States would have one year to implement these changes.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 3 benefits, 0 costs, 0 mixed.
Medicaid coverage for cancer patients
If enacted, you could qualify for Medicaid if you have certain breast or cervical cancers. States would use this new category to decide who qualifies. The change would start beginning 1 year after the date of enactment.
Medicaid covers breast reconstruction after mastectomy
If enacted, Medicaid would cover breast reconstruction after a medically necessary mastectomy. This would apply to enrollees who had that surgery. The change would start beginning 1 year after the date of enactment.
Lower Medicaid costs for cancer care
If enacted, cost-sharing protections would explicitly apply to the new cancer coverage group. This could lower or clarify out-of-pocket costs for their care. The bill would also align federal–state funding rules for this group to support their coverage. These changes would start beginning 1 year after the date of enactment.
Sponsors & CoSponsors
Sponsor
Waters, Maxine [D-CA-43]
CA • D
Cosponsors
Rep. Garcia, Sylvia R. [D-TX-29]
TX • D
Sponsored 7/17/2025
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 7/17/2025
Rep. Velázquez, Nydia M. [D-NY-7]
NY • D
Sponsored 7/17/2025
Rep. Wasserman Schultz, Debbie [D-FL-25]
FL • D
Sponsored 7/17/2025
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 7/17/2025
Rep. Clarke, Yvette D. [D-NY-9]
NY • D
Sponsored 7/17/2025
Rep. Fields, Cleo [D-LA-6]
LA • D
Sponsored 7/17/2025
Johnson (GA)
GA • D
Sponsored 7/17/2025
Rep. Tlaib, Rashida [D-MI-12]
MI • D
Sponsored 7/17/2025
Thompson (MS)
MS • D
Sponsored 7/17/2025
Sewell
AL • D
Sponsored 7/17/2025
Rep. Gottheimer, Josh [D-NJ-5]
NJ • D
Sponsored 7/17/2025
Rep. Watson Coleman, Bonnie [D-NJ-12]
NJ • D
Sponsored 7/17/2025
Rep. Thanedar, Shri [D-MI-13]
MI • D
Sponsored 7/17/2025
Rep. Lee, Summer L. [D-PA-12]
PA • D
Sponsored 7/17/2025
Rep. Latimer, George [D-NY-16]
NY • D
Sponsored 7/17/2025
Wilson (FL)
FL • D
Sponsored 7/17/2025
Rep. Veasey, Marc A. [D-TX-33]
TX • D
Sponsored 7/17/2025
Cohen
TN • D
Sponsored 7/17/2025
Rep. Lynch, Stephen F. [D-MA-8]
MA • D
Sponsored 7/17/2025
Rep. McIver, LaMonica [D-NJ-10]
NJ • D
Sponsored 7/17/2025
Rep. García, Jesús G. "Chuy" [D-IL-4]
IL • D
Sponsored 7/17/2025
Cherfilus-McCormick
FL • D
Sponsored 7/17/2025
Rep. Moore, Gwen [D-WI-4]
WI • D
Sponsored 7/17/2025
Costa
CA • D
Sponsored 7/17/2025
Rescom. Hernández, Pablo Jose [D-PR-At Large]
PR • D
Sponsored 7/22/2025
Trahan
MA • D
Sponsored 9/9/2025
Rep. McDonald Rivet, Kristen [D-MI-8]
MI • D
Sponsored 9/9/2025
McBride
DE • D
Sponsored 9/9/2025
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov