To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage of certain items and services relating to breast or chest wall reconstruction furnished in connection with breast cancer treatment.
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
The bill requires mandatory health plan coverage of all modalities of breast and chest wall reconstruction following breast cancer treatment, amending the PHSA, ERISA, and IRC, requires new PHSA Section 2799A-11 requiring group and individual health plans to cover all breast reconstruction modalities, types, and procedural variations after breast cancer treatment, and requires new IRC Section 9826 requiring group health plans subject to the tax code to cover all breast reconstruction modalities after breast cancer treatment. It relies on compliance mandates and product standards. The main policy areas are Healthcare and Finance.
Who Benefits and How
Breast cancer patients in group or individual insurance markets could face fewer barriers, Breast cancer patients in employer-sponsored plans could face fewer barriers, and Breast cancer patients electing reconstruction could face fewer barriers.
Who Bears the Burden and How
Health insurance issuers offering group or individual coverage would take on compliance duties, Health insurance issuers (group and individual market) would take on compliance duties, and Employer-sponsored group health plans (IRC-regulated) would take on compliance duties.
Key Provisions
- Requires mandatory health plan coverage of all modalities of breast and chest wall reconstruction following breast cancer treatment, amending the PHSA, ERISA, and IRC.
- Requires new PHSA Section 2799A-11 requiring group and individual health plans to cover all breast reconstruction modalities, types, and procedural variations after breast cancer treatment.
- Requires new IRC Section 9826 requiring group health plans subject to the tax code to cover all breast reconstruction modalities after breast cancer treatment.
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
The bill requires mandatory health plan coverage of all modalities of breast and chest wall reconstruction following breast cancer treatment, amending the PHSA, ERISA, and IRC, requires new PHSA Section 2799A-11 requiring group and individual health plans to cover all breast reconstruction modalities, types, and procedural variations after breast cancer treatment, and requires new IRC Section 9826 requiring group health plans subject to the tax code to cover all breast reconstruction modalities after breast cancer treatment.
Key Policy Areas
Healthcare, Finance
Primary Purpose
The bill requires mandatory health plan coverage of all modalities of breast and chest wall reconstruction following breast cancer treatment, amending the PHSA, ERISA, and IRC, requires new PHSA Section 2799A-11 requiring group and individual health plans to cover all breast reconstruction modalities, types, and procedural variations after breast cancer treatment, and requires new IRC Section 9826 requiring group health plans subject to the tax code to cover all breast reconstruction modalities after breast cancer treatment.
Policy Domains
Whole bill
Identified Gains
- Breast cancer patients in group or individual insurance markets
- Breast cancer patients in employer-sponsored plans
- Breast cancer patients electing reconstruction
- Plastic surgeons and reconstructive surgery providers
- Reconstructive surgery providers and breast surgeons
Identified Costs
- Health insurance issuers offering group or individual coverage
- Health insurance issuers (group and individual market)
- Employer-sponsored group health plans (IRC-regulated)
- Employer-sponsored group health plans
Sponsors
Legislative Progress
IntroducedMrs. Cammack (for herself, Mrs. Dingell, Mrs. Hinson, Mrs. McBath, …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Breast cancer patients electing reconstruction, Breast cancer patients in employer-sponsored plans, Breast cancer patients in group or individual insurance markets
Employer-sponsored group health plans, Employer-sponsored group health plans (IRC-regulated), Health insurance issuers (group and individual market)
Plastic surgeons and reconstructive surgery providers, Reconstructive surgery providers, Reconstructive surgery providers and breast surgeons
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