To amend title XIX of the Social Security Act to require coverage for certain individual with breast or cervical cancer under the Medicaid program.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
This bill requires all state Medicaid programs to cover individuals diagnosed with breast or cervical cancer. Currently, this coverage is optional for states; this bill makes it mandatory. It also adds breast reconstruction after mastectomy as a required covered benefit and eliminates cost-sharing requirements for these patients.
Who Benefits and How
Uninsured and low-income individuals with breast or cervical cancer benefit by gaining guaranteed Medicaid coverage in all 50 states. Hospitals and cancer treatment centers benefit from having a reliable payer source for treating these patients. Plastic surgeons performing reconstructive procedures benefit from explicit coverage of post-mastectomy reconstruction.
Who Bears the Burden and How
State Medicaid programs bear the cost of providing mandatory coverage, with potential increased enrollment and expenditures. Federal government shares this cost burden through Medicaid matching payments. Taxpayers ultimately fund the expanded coverage through federal and state tax revenues.
Key Provisions
- Moves breast/cervical cancer patient coverage from optional to mandatory for state Medicaid programs
- Adds breast reconstruction following medically necessary mastectomy as a covered benefit
- Eliminates cost-sharing (copays, premiums) for breast/cervical cancer treatment services
- Takes effect 1 year after enactment to allow states time to implement
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Requires all state Medicaid programs to provide coverage for individuals with breast or cervical cancer, making previously optional coverage mandatory and adding breast reconstruction following mastectomy as a covered benefit.
Key Policy Areas
Healthcare, Medicaid, Cancer Treatment
Primary Purpose
Requires all state Medicaid programs to provide coverage for individuals with breast or cervical cancer, making previously optional coverage mandatory and adding breast reconstruction following mastectomy as a covered benefit.
Policy Domains
Main Bill - Medicaid Cancer Coverage
Identified Gains
Contextual inference, no direct clause citation- Uninsured breast/cervical cancer patients
- Healthcare providers
- Cancer treatment centers
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- State Medicaid programs
- Federal government
- Taxpayers
Contextual inference, no direct clause citation
Sponsors
Legislative Progress
IntroducedMs. Waters (for herself, Ms. Garcia of Texas, Ms. Norton, …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
State Medicaid programs required to expand coverage
Plastic surgeons performing breast reconstruction
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