The 2025 state legislative sessions will be busy with action likely on breast health issues, including numerous bills addressing supplemental and diagnostic coverage without cost sharing to the patient and other key considerations in breast cancer prevention and care.
Several state legislatures have already pre-filed or introduced legislation related to breast health. In the first two weeks of January, 9 states (Connecticut, Florida, Hawaii, Indiana, Missouri, New York, South Carolina, Utah, and Virginia) have filed measures seeking to improve breast cancer screening statutes in their respective states.
Connecticut
Senate Bill (SB) 450 introduced by State Senator Saud Anwar seeks to define breast ultrasound as a screening procedure for insureds, thereby ensuring coverage for this service.
Florida
SB 158 would prohibit any cost-sharing requirements for diagnostic or supplemental breast examinations under the state group insurance program.
House Bill (HB) 131 would allow patients with dense breast tissue to receive ultrasound or other additional screening tests without first undergoing a conventional mammogram.
Hawaii
SB 189 would expand coverage of breast cancer screening and imaging to include an annual mammogram for a woman of any age that has an above-average risk for breast cancer as determined by the use of a risk-factor modeling tool. The bill would also require additional breast cancer screening coverage for: 1) women 30 years of age and older; and 2) additional supplemental imaging for any woman, regardless of age, as deemed medically necessary by an applicable American College of Radiology® (ACR®) guideline.
Indiana
HB 1061 requires health plans to cover diagnostic and supplemental breast examinations without any cost-sharing for patients. It was referred to the Committee on Insurance.
Missouri
SB 232 repeals state mandated provision of law relating to breast density notifications following screening mammograms.
New York
Assembly Bill (AB) 1158 would extend eligibility for covered breast cancer screenings to individuals with a second-degree (in addition to first-degree) relative who has a prior history of breast cancer.
AB 580 would treat a notice of dense breast tissue as a determination of medical necessity, thereby guaranteeing coverage of breast ultrasounds if recommended.
SB 768 would require incarcerated individuals to receive breast cancer screening and diagnostic testing in accordance with nationally recognized clinical guidelines.
SB 310 would require insurance coverage for ultrasound and other diagnostic procedures for individuals with a prior history of breast cancer or a first-degree relative with such a history.
South Carolina
HB 3202 was pre-filed and referred to the Committee on Labor, Commerce, and Industry. The measure requires health insurance policies in the state to provide coverage for diagnostic and supplemental breast examinations without cost-sharing requirements, including mammography, MRI, ultrasound, or molecular breast imaging. The legislation follows National Comprehensive Cancer Network guidelines and clarifies certain exceptions for high-deductible health plans under federal law.
Utah
HB 146 would repeal breast density notification requirement mandated by the state.
Virginia
HB 1828 was pre-filed by State Representative Shelly A. Simonds filed and referred to the House Committee on Labor and Commerce (Subcommittee #1). The bill seeks to prohibit health insurance carriers from imposing cost-sharing requirements for diagnostic and supplemental breast examinations.
VA SB 1238 is the companion for HB 1828 and was filed by State Senator Tara Durant. and referred to the Senate Committee on Commerce and Labor. This bill is a
recommendation of the Health Insurance Reform Commission.
VA HB 2133 was introduced on by State Representative Karen Keys-Gamarra. This bill also seeks to mandate coverage for diagnostic and supplemental breast examinations, but its scope focuses more specifically on high-risk patient populations.
ACR state government relations staff will collaborate closely with state radiological societies, Komen, and other stakeholders to advocate for breast health bills. For any state society currently working on breast health related legislation, ACR's Government Relations Committee of the Breast Imaging Commission stands ready to assist with review and feedback. For more information, contact
Eugenia Brandt, ACR Senior Government Relations Director.
