H.R.3037 - Access to Breast Cancer Diagnosis Act of 2025 (119th Congress)
Summary
H.R.3037, the Access to Breast Cancer Diagnosis Act of 2025, aims to eliminate cost-sharing requirements for diagnostic and supplemental breast examinations under group and individual health insurance plans. This bill amends the Public Health Service Act and the Internal Revenue Code to ensure coverage without deductibles, coinsurance, or copayments. The changes would apply to plan years beginning on or after January 1, 2026, and also affect grandfathered health plans and high-deductible health plans with Health Savings Account eligibility.
Expected Effects
The primary effect of this bill would be to increase access to diagnostic and supplemental breast examinations by removing financial barriers. This could lead to earlier detection and treatment of breast cancer, potentially improving health outcomes. It may also increase healthcare costs overall, although the bill allows for prior authorization and utilization controls.
Potential Benefits
- Increased access to potentially life-saving diagnostic and supplemental breast examinations.
- Reduced financial burden on individuals needing these examinations.
- Earlier detection of breast cancer, leading to improved treatment outcomes.
- Addresses disparities in healthcare access related to income.
- Aligns health insurance coverage with recommended medical guidelines.
Potential Disadvantages
- Potential increase in overall healthcare costs due to increased utilization.
- Possible administrative burden for insurance companies to implement the changes.
- May lead to higher premiums for all insured individuals, even those not needing these services.
- Could create a need for increased healthcare infrastructure and personnel to handle increased demand.
- Potential for overuse of diagnostic services if not managed effectively through utilization controls.
Most Disadvantaged Areas:
Constitutional Alignment
This bill appears to align with the general welfare clause of the Constitution, as it aims to promote public health by improving access to breast cancer screening and diagnosis. While the Constitution does not explicitly address healthcare, the power to regulate interstate commerce (Article I, Section 8) provides a basis for federal legislation affecting health insurance plans. The bill does not appear to infringe on any specific constitutional rights or freedoms.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).