Access to Breast Cancer Diagnosis Act of 2025

This bill, titled the "Access to Breast Cancer Diagnosis Act of 2025," amends the Public Health Service Act to prohibit group health plans and health insurance issuers from imposing cost-sharing requirements for diagnostic and supplemental breast examinations. This means that deductibles, coinsurance, copayments, and similar out-of-pocket expenses would not apply to these services. The legislation aims to remove financial barriers for individuals needing these crucial examinations, which include diagnostic mammography, breast MRI, and breast ultrasound. The bill defines diagnostic breast examinations as those used to evaluate abnormalities found during screening or by other means, while supplemental breast examinations are for screening based on increased risk factors. Importantly, the bill clarifies that it does not prevent plans from requiring prior authorization or other utilization controls, nor does it supersede stronger state laws. It also ensures that grandfathered health plans and high deductible health plans with health savings account eligibility can comply without penalty, with the provisions taking effect for plan years beginning on or after January 1, 2026.