PSA Screening for HIM Act
Sponsors
Legislative Progress
In CommitteeMr. Dunn of Florida (for himself, Ms. Clarke of New …
Summary
What This Bill Does
The PSA Screening for HIM Act requires health insurance companies to cover prostate cancer screenings without any out-of-pocket costs (copays, deductibles, or coinsurance) for high-risk men. This includes African-American men age 40 and over, and men with a family history of prostate cancer. The bill aims to catch prostate cancer early when survival rates are near 100%, rather than late-stage when only 37% survive.
Who Benefits and How
High-risk men (African-American men and those with family history) benefit the most. They will receive free prostate cancer screenings starting at age 40, removing financial barriers to early detection. African-American men, who are 70% more likely to be diagnosed and 2.1 times more likely to die from prostate cancer than white men, stand to gain significantly from improved access to screening.
Healthcare providers and urologists may see increased patient volume for prostate cancer screenings as cost barriers are eliminated. The broader healthcare system could benefit from reduced costs of treating late-stage metastatic cancer, which costs hundreds of millions more annually than treating early-stage cancer.
Who Bears the Burden and How
Health insurance companies and group health plans must absorb the cost of providing these screenings without charging patients. They cannot impose copays, deductibles, or any cost-sharing for prostate cancer screenings for eligible high-risk men.
Employers offering group health plans may see modest increases in premiums as insurers incorporate the cost of mandatory screening coverage.
Key Provisions
- Amends the Public Health Service Act to add prostate cancer screenings to the list of preventive services that must be covered without cost-sharing
- Defines "high-risk men" as those age 40+ who are African-American or have a first-degree relative who was diagnosed with, developed, or died from prostate cancer
- Includes men with relatives who have genetic alterations or cancers associated with increased prostate cancer risk
- Takes effect for plan years beginning on or after January 1, 2026
- Preserves existing breast cancer screening requirements at their November 2009 recommendation levels
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
This bill amends the Public Health Service Act to require group health plans and individual insurance providers to cover prostate cancer screenings without cost-sharing requirements for high-risk men, particularly African-American men and those with a family history of prostate cancer.
Policy Domains
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
- "the_administrator"
- → Administrator of the Centers for Medicare & Medicaid Services (CMS)
Key Definitions
Terms defined in this bill
Evidence-based preventive care and screenings for prostate cancer, including immunizations with recommendations from the Advisory Committee on Immunization Practices of the CDC.
Health plans offered by employers or unions to their employees, covering a group of individuals.
Cancer that develops in the prostate gland, with varying survival rates depending on the stage of diagnosis.
Men who are age 40 and over, including African-American men and those with a family history of prostate cancer.
Having a first-degree relative who was diagnosed, developed, or died from prostate cancer, or has genetic alterations associated with increased risk.
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