Insurance; annual prostate cancer screenings for certain men; require major medical coverage
Summary
House Bill 373 would amend Georgia’s insurance code to require major medical health benefit policies to cover annual prostate cancer screenings for men at high risk for the disease. The bill defines “health benefit policy” broadly to include individual and group major medical plans issued by insurers, HMOs, PPOs, hospital service corporations, medical service corporations, and similar entities. It also defines “men with a family history of prostate cancer” and “men with a high risk for prostate cancer,” including men ages 50 and older, men ages 40 to 49 with a family history, and other men as determined by a physician.
The required screening coverage would include both a digital rectal examination and a prostate-specific antigen (PSA) test. The bill applies to policies issued, delivered, issued for delivery, or renewed on or after January 1, 2026, and it repeals conflicting laws. In practical terms, the measure would mandate a new insurance benefit for qualifying men and require affected health insurers and related carriers to include this preventive coverage in applicable plans.
Impact
HB373 would add a new insurance coverage mandate to Title 33 of the Official Code of Georgia Annotated, specifically within the general provisions governing insurance. It would affect major medical insurers and other health benefit policy issuers by requiring them to cover annual prostate cancer screening for men deemed high risk under the bill’s definitions. The law would apply prospectively to new or renewed policies beginning January 1, 2026, and would likely increase covered preventive services and potentially insurer costs associated with the mandated benefit.
Sentiment
The bill appears to have broad support in the House, passing by a vote of 164-1 on February 28, 2025. The overwhelming vote suggests strong bipartisan or near-unanimous agreement that prostate cancer screening coverage for high-risk men is a worthwhile preventive health measure. No committee transcript was provided, so the available record shows little publicized opposition in the materials supplied.
Contention
The main policy issue is the creation of an insurance mandate, which can raise concerns about premium impacts, benefit design, and the scope of required preventive coverage. Another possible point of discussion is the bill’s age and risk definitions, including the inclusion of all men age 50 and older and physician-determined high-risk cases, which broadens the affected population. However, based on the voting record provided, any objections were limited, as the House vote was nearly unanimous.