Sponsors (7)
The bill expands and standardizes access to guideline lung cancer screening and Medicaid tobacco‑cessation benefits—improving timely preventive care and clinician burden—but raises near‑term costs for governments and insurers, risks capacity strains and some low‑value use, and requires administrative implementation at the state level.
Medicaid, Medicare, and people with private/employer coverage (including low-income Medicaid enrollees) will be able to get annual USPSTF-recommended lung cancer screening without prior authorization, increasing timely detection and removing a major administrative barrier to care.
Medicaid enrollees nationwide gain tobacco cessation counseling and FDA‑recommended pharmacotherapy coverage (without prior authorization), expanding preventive treatment access beyond pregnant people and likely improving quit rates.
Removing prior authorization for recommended lung cancer screening reduces paperwork and administrative time for clinicians, hospitals, and health systems, freeing provider time for direct patient care.
States, federal programs, insurers, and taxpayers may face higher near‑term spending due to increased use of lung cancer screening and expanded Medicaid cessation benefits, raising budgetary pressure and potential increases in premiums or program costs.
Eliminating prior authorization removes a utilization-control that insurers use to limit inappropriate or low-value screenings, which could increase unnecessary CT scans and downstream follow-up procedures.
Hospitals and imaging providers could experience capacity strains and scheduling delays from higher demand for low‑dose CT scans, especially in underserved or rural areas with limited imaging capacity.
Based on analysis of 6 sections of legislative text.
Requires annual USPSTF-recommended lung cancer screening to be covered without prior authorization or Medicaid cost-sharing, expands Medicaid tobacco cessation to all enrollees, funds outreach, and orders a GAO study.
Introduced November 20, 2025 by Kathy Castor · Last progress November 20, 2025
Requires Medicaid, Medicare, and private group plans to cover annual lung cancer screening recommended by the U.S. Preventive Services Task Force without prior authorization and, for Medicaid, without cost-sharing. Expands Medicaid coverage of tobacco cessation counseling and medications to all beneficiaries, funds HHS outreach about screening, and directs the GAO to study gaps in screening and diagnosis. Most changes take effect January 1, 2026, with a delayed compliance window for states that need enabling state legislation. The bill includes funding for a targeted education campaign ($10 million per year for 2026–2030) and requires a GAO report within one year identifying populations missed by current screening rules and recommending federal actions.