No-Cost Breast Examinations in Medicaid Act of 2026

This legislative proposal seeks to amend the Social Security Act to ensure that specific breast examinations are provided without cost-sharing for individuals covered by Medicaid. It modifies sections related to Medicaid cost-sharing, explicitly exempting diagnostic breast examinations and supplemental breast examinations from any beneficiary charges. The bill defines a diagnostic breast examination as a medically necessary evaluation of an abnormality detected through screening or other means, utilizing methods like mammography, MRI, or ultrasound. A supplemental breast examination is defined as a medically necessary screening using MRI or ultrasound, performed when no abnormality is suspected but an individual has increased risk due to personal or family history. Furthermore, the legislation designates screening mammography, as graded A or B by the United States Preventive Services Task Force, as a mandatory benefit under Medicaid. These changes are intended to take effect one year after the bill's enactment, aiming to improve access to crucial breast cancer detection services for Medicaid beneficiaries.