The "PSA Screening for HIM Act" ensures that high-risk men, including African-American men and those with a family history of prostate cancer, have access to prostate cancer screenings without cost-sharing under group health plans and insurance coverage.
Neal Dunn
Representative
FL-2
The "PSA Screening for HIM Act" aims to improve early detection of prostate cancer by requiring group health plans and health insurance issuers to cover prostate cancer screenings without cost-sharing for high-risk men aged 40 and over, including African-American men and those with a family history of the disease. This coverage mandate ensures that high-risk individuals have access to potentially life-saving screenings, aligning with the goal of reducing prostate cancer-related deaths and improving treatment outcomes. The Act defines "men with a family history of prostate cancer" as those with a first-degree relative with prostate cancer, associated cancers, or genetic alterations linked to increased risk. This provision is set to take effect for plan years starting on or after January 1, 2026.
Free Prostate Cancer Screenings for High-Risk Men Over 40: New Bill Could Save Lives, Kicks Off in 2026
The "Prostate-Specific Antigen Screening for High-risk Insured Men Act" (or the PSA Screening for HIM Act, because who doesn't love a good acronym?) is pretty straightforward: it makes prostate cancer screenings completely free for men 40 and over who are considered high-risk. We're talking zero co-pays, deductibles, or any other out-of-pocket costs. The bill specifically targets those at higher risk, effective January 1, 2026.
Who's Covered, and Why It Matters
This bill zeroes in on two groups known to be at higher risk for prostate cancer:
- African-American men: SEC. 2 Findings notes they're 70% more likely to be diagnosed and 2.1 times more likely to die from prostate cancer than White men.
- Men with a family history: If your dad, brother, or uncle had prostate cancer (or a related cancer, or a genetic alteration linked to increased risk), you're also covered. (SEC. 3)
Why is this a big deal? Because early detection is everything. The bill itself points out (SEC. 2) that the survival rate for early-stage prostate cancer is nearly 100%, but that plummets to 37% for late-stage. Catching it early means less aggressive treatment and, you know, living longer. Think of a self-employed carpenter we'll call "James." James is 45, has a family history of prostate cancer, and hasn't been screened because of the cost. This bill would allow James to get screened without worrying about the bill, potentially catching any issues early.
Real-World Rollout
Starting January 1, 2026, group health plans and individual health insurance issuers must cover these screenings without cost-sharing. (SEC. 3) "Cost-sharing" is just a fancy way of saying co-pays, deductibles, etc. – basically, any money you'd normally have to shell out. The bill uses the most current recommendations for breast cancer screening and mammography (except those issued around November 2009) as a guideline. It also allows plans to offer more services than those recommended, but explicitly states that they are not required to deny any services not recommended by the United States Preventive Services Task Force.
The Bottom Line
This bill is about removing financial barriers to a potentially life-saving screening for guys who are most at risk. It's about making sure that your zip code or family history doesn't determine your chances of surviving prostate cancer. While there will likely be increased upfront costs for insurers, the potential long-term savings (from treating early-stage vs. late-stage cancer) could be significant. It's also a step towards addressing some pretty stark health disparities.