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This bill requires health insurance plans, Medicare, Medicaid, TRICARE, and the Department of Veterans Affairs to cover additional breast cancer screening and diagnostic imaging for certain individuals at greater risk, without charging deductibles, copays, or other cost-sharing. It applies to plan years starting on or after January 1, 2026.
Sec. 2, Coverage with no cost-sharing for additional breast screenings for certain individuals at greater risk for breast cancer: This section has multiple parts. Part (a) amends the Public Health Service Act, ERISA, and the Internal Revenue Code to require group health plans and health insurance issuers to cover and not impose cost-sharing for screening and diagnostic breast imaging (like 2D or 3D mammograms, breast ultrasounds, breast MRI, molecular breast imaging, contrast-enhanced mammography) for individuals at increased risk of breast cancer or with dense breast tissue, as well as for others determined by a provider to need such imaging based on factors like age, race, ethnicity, or family history. Coverage must follow National Comprehensive Cancer Network guidelines. This also applies to grandfathered health plans.
Part (b) amends Medicare to cover these same imaging services for eligible individuals under Medicare Part B, with no cost-sharing under Medicare Advantage plans starting January 1, 2026.
Part (c) amends Medicaid to require state plans to cover these imaging services for eligible individuals, and prohibits states from charging cost-sharing for them. Benchmark and benchmark-equivalent coverage must also include these services. The effective date is January 1, 2026, with a possible delay for states needing legislative changes.
Part (d) amends TRICARE to require coverage of these imaging services for eligible uniformed service members and their families, and eliminates cost-sharing for them under TRICARE Prime, TRICARE Select, and TRICARE contracts, effective January 1, 2026.
Part (e) amends veterans' health benefits to require the Secretary of Veterans Affairs to furnish these imaging services to eligible veterans, regardless of their enrollment status, and prohibits copayments or other charges for these services, effective January 1, 2026.
Summary of the bill text as introduced in House (Nov 20, 2025), generated by SecBot from the official bill text; the Library of Congress summary is not yet published.
No amendments offered
No cost estimate or committee report yet
Official record from Congress.gov, the House Clerk and the Senate; lobbying from Lobbying Disclosure Act filings. Updated Oct 28, 2026.