States Push for Expanded Breast Imaging Coverage in 2024 Legislative Session

During the 2024 legislative sessions, many bills were introduced in the states aimed at expanding insurance coverage for breast imaging services. Many of the bills focused on requiring health insurance plans to cover supplemental and diagnostic breast examinations without patient cost-sharing. Most recently, Iowa and Vermont celebrated passage of bills into law and New Hampshire’s bill is pending the governor’s action. In addition to Iowa, Vermont and New Hampshire, states that introduced bills include Alaska, Arizona, Florida, Indiana, Kansas, Massachusetts, Michigan, Mississippi, Nebraska, North Carolina, Pennsylvania, Rhode Island, South Dakota, Virginia, West Virginia and Wisconsin.

Vermont HB 621 -Act No. 94 was signed into law by Gov. Phil Scott May 25. This new law amends current health insurance coverage requirements for mammograms, extending the coverage to include other medically necessary breast imaging services. These services must be covered by health plans when recommended by a healthcare provider for detecting breast cancer and other breast abnormalities. The act mandates that these imaging services be provided without any patient cost-sharing, except instances in which doing so would disqualify a high-deductible health plan from being eligible for a health savings account under federal law. The law will go into effect Jan. 1, 2026.

Earlier in May, Iowa Gov. Kim Reynolds signed HF 2489 into law. The measure mandates insurance coverage for supplemental and diagnostic breast examinations. Effective Jan. 1, this law requires that health insurance policies, contracts and plans cover breast imaging services without less favorable terms than those for screening mammograms. The coverage includes breast MRIs, ultrasounds, and diagnostic mammograms aimed at evaluating abnormalities or based on risk factors such as personal or family medical history. This requirement applies to various individual and group health plans, including those for public employees, but excludes accident-only, specified disease, short-term, and other specialized insurance types.

New Hampshire HB 1296 would improve insurance coverage for diagnostic and supplemental breast examinations. This legislation requires that group health plans and health insurance issuers providing these services must eliminate co-payments, deductibles and other cost-sharing requirements. The only exception is for high-deductible health plans, which must adhere to federal guidelines for health savings account eligibility; in such cases, cost-sharing would apply until the minimum deductible is met, except for preventive care services. This act defines diagnostic breast examinations as those evaluating abnormalities detected through screening or other methods, and supplemental breast examinations as screenings based on personal or family history without prior abnormalities. The law would take effect Jan. 1.

The American College of Radiology® (ACR®) partners with Fiscal Note, a legislation and regulation tracking service, to provide continuous, comprehensive updates on radiology and healthcare-related legislation. To stay current on state legislative developments relevant to radiology, view the ACR policy map.

ACR always looks for members’ advocacy efforts to highlight. If you would like to highlight someone for their advocacy work, share your advocacy experience, or share pictures from your recent state advocacy day, contact Eugenia Brandt, ACR Senior Government Affairs Director, or Dillon Harp, ACR Senior Government Relations Specialist.