HR3037

The Access to Breast Cancer Diagnosis Act of 2025, HR3037, prohibits group health plans and health insurance issuers from imposing cost-sharing requirements (deductibles, coinsurance, copayments) for diagnostic and supplemental breast examinations. This means patients will pay nothing out-of-pocket for these services. The bill explicitly allows health plans to retain prior authorization and other utilization controls. This legislation directly increases the demand for diagnostic breast examinations by removing a financial barrier for patients. Funding for these examinations shifts entirely to health insurance providers. Healthcare providers and diagnostic imaging centers will see increased patient volume for these services. Companies operating hospitals and outpatient imaging centers, such as HCA Healthcare ($HCA), stand to gain from higher procedure volumes. Diagnostic testing companies like LabCorp ($LH) and Quest Diagnostics ($DGX), which process biopsies and other related tests, will also see increased demand. Manufacturers of diagnostic imaging equipment, such as GE HealthCare Technologies ($GEHC), benefit from increased utilization and potential upgrades in facilities. Historically, similar legislation aimed at reducing out-of-pocket costs for preventative care has led to increased utilization. For example, the Affordable Care Act (ACA) of 2010 mandated coverage of preventive services without cost-sharing. While not directly comparable to diagnostic services, this precedent indicates that removing financial barriers increases access and utilization. Health insurance companies, including UnitedHealth Group ($UNH), CVS Health ($CVS) (Aetna), Elevance Health, and Humana ($HUM), will experience increased claims volume for these specific services. However, the bill's allowance for prior authorization and utilization controls mitigates the financial impact on insurers by preventing unchecked increases in procedures. Specific winners include healthcare providers and diagnostic service companies. HCA Healthcare ($HCA) will see increased patient visits for diagnostic breast examinations across its hospital and outpatient network. LabCorp ($LH) and Quest Diagnostics ($DGX) will process more diagnostic tests. GE HealthCare Technologies ($GEHC) benefits from higher utilization of its imaging equipment. Health insurance companies like UnitedHealth Group ($UNH) and Elevance Health will face higher claims payments for these specific services, but the impact is contained by their ability to manage utilization through prior authorization. The bill's sponsor, Rep. Dingell, is a senior Democrat, and the bill has 32 cosponsors, indicating moderate legislative momentum. HR3037 has been referred to the Committee on Energy and Commerce and the Committee on Ways and Means. The next step is committee consideration, which includes hearings and potential markups. If it passes committee, it moves to a floor vote in the House. Given the bipartisan sponsorship and the nature of the bill, it has a reasonable chance of advancing through the House. Senate consideration would follow. The timeline for passage is uncertain but could extend through 2025.