Coverage of breast cancer screenings by the Medical Assistance program and health insurance policies and plans

What it would have done

Summary by the Legislative Reference Bureau, the Legislature's nonpartisan drafting office. It's their wording, not ours.

This bill requires health insurance policies to cover, either fully or with a maximum out-of-pocket cost of $50, essential breast screenings beyond mammography in individuals who have had mammograms showing dense breast tissue, women who are at higher risk for cancer, or women whose health care provider considers the screenings to be medically necessary for any woman who is considered by the health care provider to have an above-average risk for breast cancer in accordance with certain guidelines. Health insurance policies are referred to in the statutes as disability insurance policies. Self-insured governmental health plans are also required to provide the coverage specified in the bill. The bill also requires coverage of those essential breast screenings by the Medical Assistance program, which is the state-administered Medicaid program that is jointly-funded by the state and federal governments and that provides health services to individuals with limited financial resources.

Health insurance policies are required under current law to cover two mammographic breast examinations to screen for breast cancer for a woman from age 45 to 49 if certain criteria are satisfied. Health insurance policies must currently cover annual mammograms for a woman once she attains the age of 50. The coverage required under current law is required whether or not the woman shows any symptoms of breast cancer and may be subject to only the same exclusions and limitations, including cost sharing, that apply to other radiological examinations under the policy. The bill does not change or eliminate the current coverage requirements for mammograms except that preferred provider plans are explicitly included in the current law and the bill's requirements.

Who's behind it

16 lawmakers are its authors⁠. 10 are Republicans and 6 are Democrats.

10 more lawmakers signed on in support⁠.