Sponsors (7)
The bill expands no‑cost, no‑prior‑authorization lung cancer screening and cessation services to more Americans—improving early detection and quitting support—at the cost of higher near‑term public and private spending, implementation burdens, and a risk of increased downstream testing and uneven state rollout.
Medicaid, Medicare, and people in employer/individual market plans who meet USPSTF/HHS criteria gain annual lung cancer screening covered without cost-sharing and without prior authorization, increasing early detection and speeding access to care.
All Medicaid enrollees gain coverage for tobacco cessation counseling and FDA‑recommended pharmacotherapy without prior authorization, expanding access to effective quitting treatments and likely reducing smoking-related illness over time.
Removing prior authorization and standardizing coverage reduces administrative burden for clinicians, hospitals, and Medicaid managed care plans, speeding scheduling and follow-up for preventive services.
States, Medicaid MCOs, Medicare, and private insurers will face higher near-term costs from increased screening and cessation services, which could raise state/federal spending and lead to higher premiums or taxpayer costs.
Removing prior authorization across programs may increase screenings for marginal or low‑risk people, producing more false positives, downstream diagnostic procedures, potential overdiagnosis, and strain on local imaging and follow‑up capacity.
Insurers and plans may offset higher screening costs by increasing other cost‑control measures (higher premiums, higher cost‑sharing in other services, or narrower networks), shifting costs to patients.
Based on analysis of 6 sections of legislative text.
Requires public and private plans to cover annual lung cancer screening without prior authorization or cost‑sharing, expands Medicaid tobacco‑cessation coverage to all beneficiaries, and funds targeted outreach.
Introduced November 20, 2025 by Kathy Castor · Last progress November 20, 2025
Requires public and private health plans to cover annual lung cancer screening recommended by the USPSTF or HHS without prior authorization or cost‑sharing, expands Medicaid coverage of counseling and FDA‑approved pharmacotherapy for tobacco cessation to all Medicaid beneficiaries (no longer limited to pregnant women), and funds a targeted HHS education campaign. It also directs the Government Accountability Office to study gaps in who is screened and diagnosed and to recommend federal actions to improve screening for missed groups. Most coverage changes take effect on January 1, 2026, with limited delay for states that require changes to state law.