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HR 8551

Early Access to Screening Act

119th Congress Introduced by Mike Lawler

The bill requires no-cost, annual mammograms starting at age 30 across Medicare, Medicaid, and private plans beginning Jan 1, 2026.

Introduced in House
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Bill Summary · HR 8551

Summary of HR 8551 (Early Access to Screening Act)

Purpose and goal

HR 8551, introduced in the 119th Congress, aims to provide no-cost coverage for annual mammography screening beginning at age 30. The bill would amend federal health coverage statutes to ensure that annual screening mammography is covered without cost-sharing for individuals over age 29, effective January 1, 2026, across Medicare, Medicaid, and private plan contexts (group health plans and health insurance issuers), as well as under the Public Health Service Act.

Key provisions and changes

  • Medicare (Title XVIII)

    • For screening mammography performed on or after January 1, 2026, no payment may be made for women under 30.
    • For women 30 and older, the bill sets a frequency rule: screening mammography performed within 11 months following a previous screening is not payable under the part.
    • Cost-sharing for screening mammography (e.g., copays, deductibles) would be eliminated (no-cost sharing) for the defined screening services after 2026.

  • Medicaid (Title XIX)

    • Mandatory coverage changes to require annual screening mammography for individuals over age 29, starting January 1, 2026, with no cost-sharing.
    • Medically needy provisions and option for alternative benefit plans would be adjusted to ensure annual screening mammography is included without out-of-pocket costs.
    • States’ benchmark or benchmark-equivalent plans under 1937 would be required to cover annual screening mammography beginning at age 30, with no deductions or charges.

  • Diagnostic, screening, preventive, and rehabilitative services (Medicaid/Medicare alignment)

    • Beginning January 1, 2026, annual screening mammography would be included as a covered preventive service for individuals over age 29.

  • Prohibition of cost sharing (all programs)

    • The Act expands prohibitions on cost sharing to explicitly include annual screening mammography described in the new section 1905(a)(13)(D) across Medicare, Medicaid, and applicable private plan contexts.
    • Applies to alternative cost-sharing structures (e.g., high-deductible or benchmark plans) as well.

  • Private plans (Group Health Plans and Group/Individual Insurance)

    • Under the Public Health Service Act, group health plans and health insurance issuers would be required to provide annual mammography screening for women over 29, with no cost-sharing, effective plan years beginning on or after January 1, 2026.

Who would be affected

  • Individuals enrolled in Medicare, Medicaid, and group/private health plans who are over age 29.
  • Administrative systems for federal and state health programs would need to adjust to remove cost-sharing and modify coverage frequencies for screening mammography starting in 2026.
  • Health care providers would have to align billing practices to reflect no-cost coverage for the mandated annual mammography.

Procedural and timeline notes

  • Effective date for the new no-cost annual screening mammography coverage is January 1, 2026.
  • The bill requires amendments across multiple titles: Social Security Act (Medicare and Medicaid provisions) and the Public Health Service Act (private plan provisions).
  • Introduced April 28, 2026, and referred to the Committee on Energy and Commerce and the Committee on Ways and Means.

Potential impact

  • Reduces or eliminates financial barriers for women to access annual mammography starting at age 30.
  • May influence preventive health behaviors and early detection of breast cancer.
  • Could have budgetary and administrative implications for federal programs and private plans, including potential increases in utilization of screening services.

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

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