WeVote
Log In

Bill

Bill

HB 1127

Affordable Maternal Access and Cancer Care Act.

2025-2026 Session Introduced by Eric Ager and 36 co-sponsors

Creates a statewide Maternal Care Access Grant Program, a Prostate Cancer Control Program, and breast imaging cost-sharing parity to improve access, early detection, and outcomes f

Passed 1st Reading
#appropriations;budgeting;cancer;dhhs;diseases&healthdisorders;healthservices;insurance;insurance #health;pregnancy;public;publichealth;women;familyissues
0
WeVote Research Nonpartisan
Bill Summary · HB 1127

Summary of HB 1127 (2025 Session) – Affordable Maternal Access and Cancer Care Act

Note: This summary presents the bill’s main goals, key provisions, who is affected, and timing requirements. It does not reflect any legislative outcome.

1) Purpose and Intent

  • The bill aims to:
    • Create a statewide Maternal Care Access Grant Program to reduce maternal mortality and severe maternal morbidity among marginalized and underserved populations.
    • Establish a Prostate Cancer Control Program to expand free or low-cost prostate cancer screening and follow-up for eligible men.
    • Achieve health coverage parity by ensuring equal cost-sharing for supplemental and diagnostic breast imaging (beyond standard screening mammography) within health insurance offerings.
  • Overall objective: Improve early detection, access to care, and health outcomes for maternal health and prostate/cancer care while addressing social determinants of health.

2) Key Provisions

A. Part I – Maternal Care Access Grant Program

  • Establishment: North Carolina Department of Health and Human Services (DHHS) must create and administer the Maternal Care Access Grant Program.
  • Purpose of grants: Fund programs to prevent maternal mortality and severe maternal morbidity among marginalized/underserved populations.
  • Eligibility: Grants awarded to eligible entities, with criteria including leadership by people from communities with historical disparities in accessing health/human services.
  • Outreach and assistance (effective July 1, 2026):
    • DHHS must conduct outreach to eligible applicants and provide application assistance.
    • Special consideration given to:
    • Applicants based in communities with high adverse maternal health outcomes.
    • Organizations led by women from marginalized populations.
    • Programs aligned with evidence-based practices for improving maternal health.
  • Grant awards:
    • Grants must range from $10,000 to $50,000 per recipient.
    • Preference for recipients whose programs address identified activities (see below) and serve marginalized/underserved communities.
    • Activities supported include:
    • Maternal mental health and treatments for substance use disorders.
    • Addressing social determinants of health (housing, transportation, nutrition, lactation support, childcare, environmental factors, etc.).
    • Health literacy and education on maternal health, pregnancy, childbirth, parenting.
    • Tailored support from doulas/perinatal health workers.
    • Culturally respectful training for perinatal workers.
    • Research on black maternal health issues.
    • Community-specific programs aligned with evidence-based practices.
  • Technical assistance: DHHS provides capacity-building, data collection, evaluation, and sustainability planning support to grant recipients.
  • Funding: General Fund appropriation of $5,000,000 (recurring) for FY 2026-2027 with specific allocations:
    • ~$93,513 for a full-time Public Health Program Coordinator IV to manage outreach, assist applicants, and prepare required reports.
    • ~$4,906,487 to operate the grant program (with up to 1% for administrative costs).
  • Reporting:
    • By Oct. 1, 2027: report on funds spent, outreach effectiveness in diversifying recipients, and recommendations to improve outreach and fund social determinants work.
    • By Oct. 1, 2028: report on funds spent in 2027-2028, program effectiveness on maternal health outcomes, and recommendations for future grant programs and funding opportunities.

B. Part II – Prostate Cancer Control Program

  • Funding: $2,000,000 (recurring) from the General Fund for FY 2026-2027 to DHHS, Division of Public Health.
  • Program scope: Statewide Prostate Cancer Control Program offering:
    • Free or low-cost prostate cancer screenings and follow-up.
    • Eligibility criteria for participants:
    • Uninsured or underinsured.
    • Not a Medicare Part B or Medicaid beneficiary.
    • Age 50-70 without a family history of prostate cancer; or age 40-70 with a family history (defined to include first-degree relatives with cancer or genetic risk factors).
    • Household income below 250% of the federal poverty level.
  • Objective: Increase early detection and reduce disparities in prostate cancer outcomes among eligible men.

C. Part III – Health Insurance Regulation Changes to Create Parity for Supplemental and Diagnostic Breast Imaging

  • Coverage parity standards:
    • Recasts several sections to ensure coverage parity between diagnostic/supplemental breast imaging and screening breast imaging.
    • Definitions clarified for diagnostic, supplemental, and screening examinations, including mammography, breast MRI, ultrasound, and cervical cancer screening.
    • Cost-sharing parity: Insurance plans must apply cost-sharing for diagnostic/supplemental imaging no less favorable than for low-dose screening mammography.
    • Network parity: Insurers cannot reimburse non-contracted providers at higher rates than contracted providers for these breast imaging services.
    • Screening schedule: Establishes coverage for at-risk individuals (annual or more frequent mammograms as advised), and baseline coverage for women aged 35-39, plus biennial or annual schedules for other age groups.
    • Accreditation: Reimbursement for mammograms requires accredited facilities.
    • Cervical cancer screening: Coverage aligns with ACS/ACOG guidelines; laboratory/services reimbursements require accreditation.
    • High-Deductible Health Plans (HDHPs): Provisions respect Section 223, with preventive care exceptions.
  • State Health Plan alignment: Applies to the State Health Plan for Teachers and State Employees to ensure compliance with breast cancer screening/imaging coverage.
  • Effective date: July 1, 2026; general applicability to contracts issued/renewed/amended on or after that date.

D. Part IV – Healthcare Provider Billing Parity for Breast Imaging

  • Billing requirements: For non-contracted providers, reimbursement must be the same as the insurer would pay to contracted providers for breast cancer prevention services.
  • Prohibition on extra charges: Providers cannot bill patients beyond the insurer’s reimbursement amount for these services.
  • Effective date: October 1, 2026 (services from that date forward).

E. Part V – Effective Date

  • Overall effective date: July 1, 2026, unless otherwise stated.

3) Who Would Be Affected

  • Maternal health providers and organizations serving marginalized/underserved communities in North Carolina.
  • Pregnant and postpartum individuals at risk of maternal mortality/morbidity, particularly those facing social determinants of health barriers.
  • Uninsured/underinsured men aged 40-70 (or 50-70 with specifics) eligible for the Prostate Cancer Control Program.
  • Insurers, health plans, and health care providers (including non-contracted providers) regarding parity requirements for breast imaging.
  • State Health Plan participants and administrators (reflecting parity in breast cancer imaging coverage).

4) Procedural and Timeline Details

  • Outreach and application assistance for the Maternal Care Access Grant Program begins July 1, 2026.
  • First grant awards window is not dated, but the outreach and assistance activities commence mid-2026; ongoing administration follows.
  • Annual or ongoing reporting deadlines:
    • October 1, 2027: program expenditure report, outreach effectiveness, and diversification recommendations.
    • October 1, 2028: expenditure report for 2027-2028, program effectiveness, and future funding recommendations.
  • Funding availability:
    • Maternal Care Access Grant Program: $4,906,487 for grants (with up to 1% for admin) plus $93,513 for a dedicated coordinator (total $5,000,000 in 2026-27).
    • Prostate Cancer Control Program: $2,000,000 recurring for 2026-27.
    • Administrative and coordination roles are embedded in the grant program funding and separate DHHS allocations.
  • Effective date for major sections:
    • Parity and insurance provisions: effective July 1, 2026 (contractual applicability on/after that date).
    • Billing parity for breast imaging: effective October 1, 2026.

5) Summary of What Changes This Bill Would Implement

  • Creates a new grant program to fund maternal health initiatives targeting disparities.
  • Establishes a state-funded program to expand access to prostate cancer screening for at-risk men.
  • Shifts and standardizes insurance cost-sharing and reimbursement for breast imaging to ensure parity between diagnostic/supplemental and screening imaging, with network-based reimbursement safeguards and accreditation requirements.
  • Extends state plan and provider billing requirements to align with these imaging parity objectives.
  • Commits recurring General Fund dollars to support these programs and requires regular reporting to legislative oversight bodies.

If you’d like, I can provide a section-by-section comparison to existing NC law or a quick bullet list of potential implementation challenges and questions for staff.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.