Seven States Enact Breast Health Legislation

The 2025 state legislative sessions have seen substantial activity around breast health, with a focus on eliminating patient cost-sharing for diagnostic and supplemental imaging, aligning state mammography notification requirements with federal standards and expanding access to breast cancer screenings. Seven states – Arkansas, Colorado, Florida, Oklahoma, Texas, Utah, and Virgina enacted breast health measures so far this year. The American College of Radiology^® (ACR^®) is tracking more than 50 bills related to breast health and is actively working with state radiological societies as they advocate for these measures.

In states with year-round legislatures, several breast health measures remain under consideration and could still advance in 2025. Among the pending proposals are bills in New York, including Assembly Bill (AB) 580, Senate Bill (SB) 2395, SB 310, SB 3559, and SB 4072 — all of which aim to expand insurance coverage for breast imaging or designate dense breast notifications as medical necessity for follow-up ultrasounds. In Pennsylvania, House Bill (HB) 433 remains in the Senate and would broaden coverage for mammographic and breast imaging exams, while HB 1602 would update key definitions under the state’s Breast and Cervical Cancer Early Screening Act.

Enacted bills include:

Arkansas

HB 1309 (Act 268) amends state law to ensure that health insurers cover all breast cancer diagnostic exams (i.e., mammograms and supplemental ultrasounds, MRI) without imposing any copayments or deductibles. The bill also clarifies that any diagnostic breast exam cost-sharing must be no less favorable than a routine screening mammogram. The bill was signed by Gov. Huckabee Sanders March 12.

SB 123 (Act 553) amends state law to broaden insurance coverage requirements for mammograms and breast ultrasounds by defining “supplemental breast examinations” to include contrast‑enhanced mammography, breast MRI, ultrasound and molecular imaging for those at elevated risk—including based on family history, dense tissue, or personal risk factors. The insurers must cover both diagnostic and supplemental breast exams without imposing any cost-sharing obligations. The bill was signed by Gov. Huckabee Sanders April 14.

Colorado

SB 25‑296 expands insurer preventive‑care coverage, including supplemental breast exams at no cost‑share. The enacted bill revises Colorado’s preventive‑care coverage law by relocating high-risk screening provisions, defining both diagnostic and supplemental breast exams and clarifying eligibility under nationally recognized screening guidelines. It mandates that health insurers cover medically necessary diagnostic and supplemental breast imaging — beyond routine screening—with no patient cost‑sharing, including no deductibles, copays, or coinsurance. The bill passed both chambers unanimously, was signed by Gov. Polis May 29. It takes effect Aug. 6.

Florida

SB 158 (Chapter 2025‑44) prohibits the state group insurance program from imposing any out‑of‑pocket cost (deductible, coinsurance, copayment, etc.) on enrollees for medically necessary diagnostic or supplemental breast imaging exams. It defines “diagnostic” and “supplemental” breast examinations in line with current National Comprehensive Cancer Network (NCCN) guidelines — including mammography, MRI, and ultrasound and applies the no‑cost‑sharing rule across any state‑employee health plan offering such coverage. It also includes a provision to limit the cost‑sharing waiver under health savings account rules only to the plan’s deductible beyond the IRS‑required minimum. The bill was signed into law by Gov. DeSantis May 20 and is effective Jan. 1, 2026. 

Oklahoma

HB 1389 expands the state’s mammography insurance mandate to cover low‑dose mammography and adds advanced imaging modalities — such as MRI and ultrasound  as insured benefits for breast cancer screening purposes. It clarifies definitions of covered exams and extends no-cost or mandated coverage regardless of zip code. The bill was vetoed by Gov. Stitts on May 6 but the Legislature voted to override his veto on May 29. It takes effect Nov. 1.

Texas

SB 1084 aligns state mammography reporting to federal standards. The bill was signed by Gov. Abbott and is effective Sept. 1.

Utah

HB 146 deletes state‑specific dense‑breast notice and instead aligns the notice with federally mandated language. Gov. Cox signed the bill March 24 and it took effect May 7.

Virginia

HB 1828/ VA SB 1436 forbids carriers from charging copays, coinsurance, or deductibles for both diagnostic and supplemental breast imaging (mammograms, MRI, ultrasound) under individual and group plans issued or renewed on/after Jan. 1, 2026. “Diagnostic” exams address suspicious findings or abnormalities detected via screening, while “supplemental” scans target those at elevated risk per NCCN guidelines—even if no prior abnormality is present. The bill is effective July 1.

 

For any state society looking to advance breast health related legislation, the College’s Government Relations Committee of the Breast Imaging Commission is ready to assist with review and feedback. For more information, contact Eugenia Brandt, ACR Senior Government Relations Director.