The "PSA Screening for HIM Act" ensures that group health plans and health insurance issuers provide coverage for prostate cancer screenings without cost-sharing for high-risk men, including African-American men and those with a family history, starting in 2025. This aims to improve early detection and survival rates for those at higher risk of prostate cancer.
John Boozman
Senator
AR
This bill, known as the "PSA Screening for HIM Act," mandates that group health plans and health insurance issuers provide coverage for prostate cancer screenings without cost-sharing for high-risk men, including African-American men and those with a family history of prostate cancer, starting in 2025. The goal is to improve early detection and survival rates for those at higher risk of developing prostate cancer. This bill ensures coverage aligns with current recommendations for breast cancer screening and prevention, while also allowing plans to offer additional services.
New 'PSA Screening for HIM Act' Mandates Free Prostate Cancer Screenings for High-Risk Men Starting 2025
The "PSA Screening for HIM Act" is pretty straightforward: it makes sure that guys at high risk for prostate cancer can get screened without having to shell out any cash. Starting January 1, 2025, health insurance plans have to cover these screenings with no copays, deductibles, or other cost-sharing for certain men 40 and older. (SEC. 3).
Who's Covered?
This is mainly aimed at two groups: African-American men and those with a family history of prostate cancer. (SEC. 3) The bill flags these groups because the stats are pretty stark. African-American men are 70% more likely to be diagnosed and over twice as likely to die from the disease compared to White men. (SEC. 2) If you've got a close relative (dad, brother, son) who's had prostate cancer, or even related cancers or certain genetic issues, you're also considered high-risk and covered. (SEC. 3) The bill actually defines "family history" pretty broadly, even including relatives who've had related cancers, not just prostate cancer, or who have certain genetic alterations. (SEC.3)
Real-World Rollout
Imagine your dad had prostate cancer. Under this law, starting next year, you could get screened, and your insurance has to foot the bill. No out-of-pocket costs. This is a big deal because early detection is key. The bill points out that catching it early means a near 100% survival rate, but if it's caught late, that drops to 37%. (SEC. 2) For a construction worker who might be putting off a checkup because of the cost, or an office worker worried about a deductible, this removes a major barrier.
The Bigger Picture (and a Potential Wrinkle)
The whole point here is to catch prostate cancer early, especially in guys who are more likely to get it. That could mean fewer late-stage diagnoses and, ultimately, lower healthcare costs down the line. Treating advanced prostate cancer is way more expensive than catching it early. (SEC. 2). The bill is all about making sure more high risk men, like a small store manager with a family history or a delivery driver who's African American, are more likely to get checked. However, there's a slightly odd bit in the bill: it references following the "most current recommendations" for breast cancer screening, except for some from around 2009. (SEC. 3). That feels a little out of place in a prostate cancer bill, and it's not totally clear why it's there, or how it will impact the bill's implementation. Also, the broad definition of 'family history,' might mean more screenings than initially anticipated, which might impact costs.