Medicaid Breast Cancer Access to Treatment Act

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4543 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 4543

 To amend title XIX of the Social Security Act to require coverage for 
 certain individual with breast or cervical cancer under the Medicaid 
                                program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 17, 2025

     Ms. Waters (for herself, Ms. Garcia of Texas, Ms. Norton, Ms. 
Velazquez, Ms. Wasserman Schultz, Mrs. Dingell, Ms. Clarke of New York, 
    Mr. Fields, Mr. Johnson of Georgia, Ms. Tlaib, Mr. Thompson of 
   Mississippi, Ms. Sewell, Mr. Gottheimer, Mrs. Watson Coleman, Mr. 
Thanedar, Ms. Lee of Pennsylvania, Mr. Latimer, Ms. Wilson of Florida, 
Mr. Veasey, Mr. Cohen, Mr. Lynch, Mrs. McIver, Mr. Garcia of Illinois, 
   Mrs. Cherfilus-McCormick, Ms. Moore of Wisconsin, and Mr. Costa) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend title XIX of the Social Security Act to require coverage for 
 certain individual with breast or cervical cancer under the Medicaid 
                                program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid Breast Cancer Access to 
Treatment Act''.

SEC. 2. REQUIRING MEDICAID COVERAGE FOR CERTAIN INDIVIDUALS WITH BREAST 
              OR CERVICAL CANCER UNDER THE MEDICAID PROGRAM.

    (a) In General.--Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended--
            (1) in subsection (a)(10)--
                    (A) in subparagraph (A)--
                            (i) in the matter preceding clause (i), by 
                        striking ``and (30)'' and inserting ``(30), and 
                        (32)'';
                            (ii) in clause (i)--
                                    (I) in subclause (VIII), by 
                                striking ``or'' at the end;
                                    (II) in subclause (IX), by adding 
                                ``or'' at the end; and
                                    (III) by adding at the end the 
                                following new subclause:
                            ``(X) who are described in subsection (aa) 
                        (relating to certain breast or cervical cancer 
                        patients);''; and
                            (iii) in clause (ii), by striking subclause 
                        (XVIII); and
                    (B) in the matter at the end, in subdivision (XIV), 
                by striking ``subparagraph (A)(10)(ii)(XVIII)'' and 
                inserting ``subparagraph (A)(10)(i)(X)''; and
            (2) in subsection (aa)--
                    (A) by striking paragraphs (1) and (2);
                    (B) by redesignating paragraphs (3) and (4) as 
                paragraphs (1) and (2), respectively; and
                    (C) in paragraph (2), as so redesignated, by 
                inserting ``as in effect on the day before the date of 
                the enactment of the Patient Protection and Affordable 
                Care Act,'' after ``(42 U.S.C. 300gg(c)),''.
    (b) Inclusion of Breast Reconstruction as Medical Assistance.--
Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is 
amended--
            (1) in paragraph (31), by striking ``and'' at the end;
            (2) by redesignating paragraph (32) as paragraph (33); and
            (3) by inserting after paragraph (31) the following new 
        paragraph:
            ``(32) breast reconstruction following a medically 
        necessary mastectomy; and''.
    (c) Conforming Amendments.--
            (1) FMAP.--Section 1905(b)(4) of the Social Security Act 
        (42 U.S.C. 1396d(b)(4)) is amended by striking ``section 
        1902(a)(10)(A)(ii)(XVIII)'' and inserting ``section 
        1902(a)(10)(A)(i)(X)''.
            (2) Cost sharing.--
                    (A) In general.--Subsections (a)(2) and (b)(2) of 
                section 1916 of the Social Security Act (42 U.S.C. 
                1396o) are each amended--
                            (i) in subparagraph (I), by striking ``or'' 
                        at the end;
                            (ii) in subparagraph (J), by striking ``; 
                        and'' at the end and inserting ``, or''; and
                            (iii) by adding at the end the following 
                        new subparagraph:
            ``(K) items and services furnished to individuals described 
        in section 1902(aa); and''.
                    (B) Alternative cost sharing.--Section 1916A(b)(3) 
                of the Social Security Act (42 U.S.C. 1396o-1(b)(3)) is 
                amended--
                            (i) in subparagraph (A)(v), by striking 
                        ``1902(a)(10)(A)(ii)(XVIII)'' and inserting 
                        ``1902(a)(10)(A)(i)(X)''; and
                            (ii) in subparagraph (B)(viii), by striking 
                        ``1902(a)(10)(A)(ii)(XVIII)'' and inserting 
                        ``1902(a)(10)(A)(i)(X)''.
    (d) Effective Date.--The amendments made by this section shall 
apply beginning 1 year after the date of the enactment of this Act.
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