PSA Screening for HIM Act
Summary
What This Bill Does
The PSA Screening for HIM Act amends Public Health Service Act preventive services coverage. Starting with plan years on or after January 1, 2026, group health plans and health insurance issuers must cover, without cost sharing, evidence-based preventive care and screenings for prostate cancer for men age 40 and older who are at high risk, including African-American men and men with a family history of prostate cancer. The bill defines family history broadly to include first-degree relatives diagnosed with, developing, or dying from prostate cancer, relatives with cancers associated with increased prostate cancer risk, and relatives with genetic alterations associated with increased risk. The findings emphasize late-stage survival gaps, 1-in-8 lifetime diagnosis risk, disproportionate risk for African-American men, and the cost difference between localized and metastatic disease.
Who Benefits and How
High-risk men age 40 and older benefit from prostate cancer screening coverage without cost sharing. African-American men benefit because the bill specifically recognizes their elevated diagnosis and mortality risk. Men with family history benefit from a defined preventive-screening right under group and individual coverage. Urologists and primary care clinicians benefit if coverage barriers to early screening discussions are reduced.
Who Bears the Burden and How
Group health plans and health insurers must cover qualifying prostate cancer screenings without deductibles, copayments, or coinsurance. Employers sponsoring health plans may face higher premium costs if screening use increases. HHS and insurance regulators must implement the revised preventive services requirement for 2026 plan years. Plan administrators must identify covered high-risk men and apply the family-history definition.
Key Provisions
- Requires no-cost prostate cancer preventive screenings for high-risk men age 40 and older.
- Expands the high-risk group to include African-American men and men with defined family history.
- Provides that the coverage change applies to plan years beginning on or after January 1, 2026.
- Adds prostate cancer screening protections to the broader preventive-services coverage structure.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Requires group health plans and health insurers to cover evidence-based prostate cancer preventive screenings without cost sharing for high-risk men age 40 and older, including African-American men and men with family history.
Key Policy Areas
Health Care, Insurance, Cancer
Primary Purpose
Requires group health plans and health insurers to cover evidence-based prostate cancer preventive screenings without cost sharing for high-risk men age 40 and older, including African-American men and men with family history.
Policy Domains
Resolution provisions
Identified Gains
- High-risk men
- African-American men
- Men with family history
- Urologists
Identified Costs
- Group health plans
- Employers sponsoring health plans
- HHS
- Plan administrators
Sponsors
Legislative Progress
In CommitteeMr. Dunn of Florida (for himself, Ms. Clarke of New …
Referred to the House Committee on Energy and Commerce.
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology