No-Cost Breast Examinations in Medicaid Act of 2026
HB8729, the No-Cost Breast Examinations in Medicaid Act of 2026, would amend the Social Security Act to prohibit cost sharing for certain breast cancer-related services under Medicaid. Specifically, it would require states and Medicaid managed care arrangements to cover diagnostic breast examinations and supplemental breast examinations without copayments, deductibles, or other out-of-pocket charges. The bill defines these services to include medically necessary breast imaging such as diagnostic mammography, breast MRI, and breast ultrasound when used to evaluate an abnormality or to screen individuals at elevated risk based on personal or family history or other factors.
The bill also makes screening mammography a mandatory Medicaid benefit when it receives an A or B recommendation from the U.S. Preventive Services Task Force. In effect, this would expand the baseline Medicaid benefit package and standardize coverage for breast cancer screening and follow-up care across states. The amendments would take effect one year after enactment, giving states and Medicaid administrators time to update coverage rules and claims systems.
HB8729 would directly amend sections 1902, 1905, 1916, and 1916A of the Social Security Act, changing Medicaid cost-sharing rules and benefit requirements nationwide. It would remove cost sharing for defined diagnostic and supplemental breast exams and add screening mammography as a mandatory covered service when USPSTF-rated A or B, affecting state Medicaid plans, managed care contracts, and beneficiary access to breast cancer screening and diagnostic imaging. The bill would likely reduce out-of-pocket costs for Medicaid enrollees and could increase state Medicaid spending depending on utilization and reimbursement patterns.
The available context suggests generally favorable treatment of the bill, as reflected by its introduction by bipartisan sponsors and referral to committee without recorded opposition or votes. The bill’s title and structure indicate a health-access measure aimed at reducing financial barriers to breast cancer detection and follow-up care. No committee transcript or vote history is available in the provided materials, so there is no recorded debate to indicate broader support or resistance.
No specific points of contention are documented in the provided materials. Potential areas of debate, based on the bill text, could include the fiscal impact on state Medicaid programs, the scope of the new mandatory benefit, and the use of National Comprehensive Cancer Network Guidelines and USPSTF recommendations to define covered services. However, no members, stakeholders, or committee participants are identified as raising objections in the available record.