H.R. 4543

119 HR 4543 IH: Medicaid Breast Cancer Access to Treatment Act
 U.S. House of Representatives
 2025-07-17
 text/xml
 EN
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 I  119th CONGRESS  1st Session  H. R. 4543  IN THE HOUSE OF REPRESENTATIVES   July 17, 2025   Ms. Waters  (for herself,  Ms. Garcia of Texas ,  Ms. Norton ,  Ms. Velázquez ,  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. García 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.
1.
Short title
This Act may be cited as the   Medicaid Breast Cancer Access to Treatment Act  .
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.