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Requires no-cost-sharing coverage of expanded breast cancer screening and diagnostic imaging for people at increased risk or with dense breasts, and for people a clinician identifies as needing imaging based on factors such as age, race, ethnicity, or personal/family history. The requirement applies across private group and individual plans, Medicare (Part B and Medicare Advantage), Medicaid, TRICARE, and VA health care, removes frequency limits on covered imaging, relies on ACR BI-RADS and applicable ACR/NCCN guidance to define eligible individuals, and takes effect January 1, 2026 (with a limited Medicaid state-delay option).
The bill expands no-cost, guideline-aligned breast imaging for people at higher risk or with dense breasts—improving early detection and lowering patient costs—while increasing public/private health spending, straining provider capacity, and raising the likelihood of incidental findings and downstream care.
Women at higher breast-cancer risk and those with dense breasts — including Medicare, Medicaid, TRICARE, and VA beneficiaries — will have expanded access to breast imaging (including advanced modalities) with no cost-sharing starting Jan 1, 2026, improving early detection.
Seniors and other covered beneficiaries who meet the criteria will face lower out-of-pocket costs because Medicare Part B, Medicare Advantage, TRICARE, VA, and Medicaid must cover the imaging without copayments.
Making these imaging services mandatory Medicaid benefits and prohibiting benchmark plans from excluding them increases access for low-income people on Medicaid who meet clinical criteria.
Insurers and federal/state programs will incur higher costs to cover more imaging without cost-sharing, which could increase premiums, raise taxpayer spending, or create budgetary pressure for states.
Greater use of advanced imaging (MRI, molecular imaging) may produce more incidental findings that lead to anxiety, additional diagnostic procedures, and downstream medical costs for patients.
Health systems and providers may face capacity constraints (imaging equipment and specialist availability) if demand rises, potentially lengthening wait times for imaging and follow-up care.
Introduced April 10, 2025 by Amy Klobuchar · Last progress April 10, 2025