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SB 25-296

Insurance Coverage for Breast Cancer Examinations

2025 Regular Session Introduced by Judy Amabile and 51 co-sponsors

SB 25-296 requires health insurers to cover breast cancer screenings and diagnostic exams, lowering costs and boosting access for insured people; impacts plans and providers.

Governor Signed
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Bill Summary · SB 25-296

Summary — SB 25‑296: Insurance Coverage for Breast Cancer Examinations

Status: Governor signed (May 29, 2025)
Introduced: April 15, 2025
Primary sponsors: Katie Stewart; Shannon Bird; Dafna Michaelson Jenet (and many cosponsors)
Legislative action: Passed both chambers with no amendments; sent to Governor May 8, 2025; signed by Governor May 29, 2025.

Main purpose and intent

SB 25‑296 is enacted to require health insurance coverage for breast cancer examinations. The bill’s title indicates its objective is to ensure insured individuals have access to breast cancer screening and diagnostic examinations through their health plans. The measure is intended to improve early detection of breast cancer and reduce financial barriers to screening.

Key provisions (summary based on bill title and legislative intent)

The bill text is not included here. Based on the bill title and standard legislative practice for similar laws, SB 25‑296 most likely does one or more of the following:
- Requires health insurers, health maintenance organizations, and other regulated health plans to cover breast cancer examinations (such as screening mammograms and clinical breast exams) and related diagnostic services.
- Defines the types of covered examinations (screening and diagnostic mammography, ultrasounds, MRI, and clinical breast exams) and establishes minimum frequency or aligns coverage with clinical guidelines (for example, U.S. Preventive Services Task Force or state public‑health recommendations).
- Addresses cost‑sharing: it may prohibit or limit copayments, coinsurance, or deductibles for covered screening services, particularly preventive exams.
- Specifies which plans are affected (individual, small‑group, large‑group, and possibly Medicaid or state employee plans).
- May include implementation, enforcement, and compliance provisions for the state insurance commissioner, and possible exemptions or grandfathering language.

Because the bill text is not included in the provided materials, readers should consult the enacted statute for precise definitions, coverage requirements, age or risk criteria, frequency limits, cost‑sharing rules, and any exceptions.

Who is affected

  • Consumers/patients: people with state‑regulated health insurance will be directly affected—potentially improved access to breast cancer screening and reduced out‑of‑pocket costs.
  • Health insurers and managed care plans: required to modify benefit design, claims processing, and provider networks to comply.
  • Health care providers: radiologists, technicians, primary care and specialty providers may see changes in referrals and reimbursement processes.
  • State programs and budget: if the law applies to public plans (Medicaid, state employee plans), there may be fiscal implications for state health budgets.

Timeline and implementation

  • Passed both chambers without amendment in late April–early May 2025.
  • Sent to and signed by Governor on May 29, 2025.
  • Effective date is not provided here; consult the enrolled bill or state statutes to confirm when the law takes effect and any phased compliance dates for insurers.

Notes and recommended next steps

  • To evaluate the law’s specific consumer protections and fiscal impact, review the enacted bill text and any accompanying fiscal notes.
  • For affected insurers or providers, review implementation guidance from the state insurance regulator once available.

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

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