This act mandates no-cost coverage for annual screening mammograms for women over 29 under Medicare, Medicaid, and private insurance, beginning in 2026.
Michael Lawler
Representative
NY-17
The Early Access to Screening Act aims to standardize and improve access to annual screening mammograms. It mandates that Medicare, Medicaid, and private insurance plans cover annual screening mammography for women over the age of 29, beginning in 2026. Furthermore, the bill prohibits cost-sharing (deductibles, copayments, etc.) for these preventative services under these programs.
New Bill Mandates No-Cost Mammograms from Age 30: Medicare, Medicaid, and Private Insurance to Cover Screenings by 2026
Alright, let's talk about something that actually matters for a lot of you out there. We've got a new piece of proposed legislation, the “Early Access to Screening Act,” that's looking to shake up how we approach breast cancer detection. And honestly, it's a pretty straightforward win for folks trying to stay on top of their health without breaking the bank.
The Early Bird Gets the Scan
Starting January 1, 2026, this bill says that if you're a woman over 29, Medicare is going to cover your annual screening mammogram. No more waiting until 40 or 50 for that first no-cost check-up. The bill, specifically in SEC. 2. (a), sets this new age floor, meaning Medicare won't pay for screenings for anyone under 30. But for those 30 and up, it's a go, once every 11 months. This is a pretty big deal for younger women who might have risk factors or just want peace of mind.
Bye-Bye, Co-Pays: Your Wallet Gets a Break
Here’s where it gets even better for your budget. Under SEC. 2. (b), if this bill passes, Medicare will cover 100% of the allowed amount for these screening mammograms starting in 2026. That means no deductibles, no co-insurance, and no co-payments. Imagine that: a crucial health screening, completely free at the point of service. For anyone juggling rising costs, this is a breath of fresh air. It's one less financial hurdle to jump over when you're trying to prioritize your health.
Medicaid and Private Plans Join the Party
It’s not just Medicare getting in on the act. The bill extends these benefits to Medicaid and private insurance too. SEC. 2. (c) mandates that state Medicaid programs must provide annual screening mammograms for individuals over 29, also starting January 1, 2026. And just like with Medicare, SEC. 2. (d) explicitly prohibits states from charging any deductibles or co-pays for these screenings. So, if you rely on Medicaid, you'll get the same no-cost access. Similarly, SEC. 2. (e) amends the Public Health Service Act to require group health plans and health insurance issuers to cover annual mammography screenings for women over 29, for plan years beginning on or after January 1, 2026. This means whether you're covered by Medicare, Medicaid, or your employer's plan, these screenings should be fully covered.
What This Means for You
In plain English, this bill aims to make early breast cancer detection more accessible and affordable for millions of women. If you're 30 or older, you won't have to worry about a bill after your annual mammogram, regardless of your insurance type. This could mean catching potential issues sooner, leading to better outcomes, and frankly, a lot less stress about the cost of staying healthy. It's a clear move towards removing financial barriers from preventative care, which is something we can all get behind.