Counties - Cancer Screening for Professional Firefighters - Required Coverage (James "Jimmy" Malone Act)
SB 374, the James “Jimmy” Malone Act, requires certain health insurers, nonprofit health service plans, and health maintenance organizations to cover preventive cancer screenings for professional firefighters. The required screenings must follow the latest guidelines issued by the International Association of Fire Fighters, and the bill generally bars insurers from charging copayments, coinsurance, or deductibles for that coverage. An exception allows the screening to remain subject to a high-deductible health plan’s deductible rules under federal tax law.
The bill also extends similar requirements to county and municipal self-insured employee health benefit plans and directs the Secretary of Budget and Management to ensure the State Employee and Retiree Health and Welfare Benefits Program complies with the new coverage mandate. Counties may satisfy the requirement either by providing a no-cost annual exam that includes the screenings or by applying for a state grant to help pay for innovative cancer screening technologies, including multi-cancer early detection blood tests. The Maryland Health Care Commission must collect data from counties for 2026 and 2027 and study whether the coverage mandate should be expanded to the commercial insurance market.
In practical terms, the bill amends the Insurance Article, Local Government Article, and State Personnel and Pensions Article to create a new statewide coverage standard for firefighter cancer screening benefits. It applies to policies, contracts, and health benefit plans issued, delivered, or renewed on or after January 1, 2026. Counties subject to the law must also report screening and cost data to the Maryland Health Care Commission, which then must report its findings to the General Assembly by December 1, 2028.
The overall sentiment around the bill appears strongly supportive and noncontroversial. The recorded votes were unanimous in both chambers, with 47-0 in the Senate and 131-0 in the House, indicating broad bipartisan agreement. No committee transcript excerpts were provided, and the vote totals suggest the measure was viewed as a targeted health benefit expansion for firefighters rather than a contested insurance mandate.
The main policy issues embedded in the bill are cost, implementation, and scope. Counties and public employers may be concerned about the expense of providing screenings and the administrative burden of collecting and reporting data, while the grant option appears designed to ease that burden. The only explicit limitation in the coverage mandate is the high-deductible health plan exception, and the study requirement signals that lawmakers may revisit whether similar protections should later apply to the broader commercial insurance market.
SB 374 creates a new statutory requirement in Maryland that certain private insurers, nonprofit health service plans, HMOs, county and municipal self-insured plans, and the State employee health benefits program cover preventive cancer screenings for professional firefighters without cost-sharing, subject to a high-deductible health plan exception. It adds new provisions to the Insurance Article, Local Government Article, and State Personnel and Pensions Article, and it requires counties to either provide no-cost annual exams or seek grant funding for screening technologies. The bill also establishes reporting and study requirements that could inform future expansion of firefighter screening coverage to the commercial market.
The bill appears to have enjoyed very strong support and little visible opposition. It passed the Senate 47-0 and the House 131-0, which indicates unanimous or near-unanimous approval in both chambers. The absence of recorded committee debate in the provided materials also suggests the measure was broadly accepted as a firefighter health and safety bill.
The principal areas of potential contention are fiscal and administrative rather than ideological. Counties and public employers may object to the cost of providing screenings, the prohibition on copays and deductibles, and the obligation to collect and report data for two years. The bill addresses some of those concerns by allowing counties to use an annual no-cost exam or apply for a grant to fund innovative screening technologies. A secondary point of policy tension is the bill’s limited scope: it covers professional firefighters specifically and does not immediately extend the same mandate to the broader commercial insurance market, though the Maryland Health Care Commission must study that possibility.