PSA Screening for HIM Act

Bill Number

H.R. 1300

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-02-13: Referred to the House Committee on Energy and Commerce.

Last Updated

2026-05-11T19:52:50Z

AI-Generated Summary

Purpose

The legislation, titled the "Prostate-Specific Antigen Screening for High-risk Insured Men Act" (or "PSA Screening for HIM Act"), aims to improve early detection of prostate cancer by requiring health insurance plans to cover screening tests for high-risk men without any out-of-pocket costs (like copays or deductibles). It addresses the high incidence and mortality of prostate cancer, particularly among African-American men and those with a family history, by minimizing financial barriers to preventive care.

Key Provisions

• Mandatory Coverage for Screenings: Group health plans and health insurance issuers offering group or individual coverage must provide free access to evidence-based prostate cancer screenings (such as PSA tests) for men aged 40 and older who are at high risk. High-risk groups include:
• African-American men.
• Men with a family history of prostate cancer, defined as having a first-degree relative (parent or sibling) who was diagnosed with, developed, died from, or had a genetic link to prostate cancer or related risks.
• Integration into Preventive Services: This requirement is added to the existing list of no-cost preventive health services under the Public Health Service Act, alongside recommendations from bodies like the U.S. Preventive Services Task Force (USPSTF), Advisory Committee on Immunization Practices, and Health Resources and Services Administration.
• Clarifications:
• Upholds current USPSTF recommendations on breast cancer screening, excluding those from around November 2009.
• Allows plans to offer additional preventive services beyond these requirements but does not require coverage for non-recommended services.
• Effective Date: Applies to plan years starting on or after January 1, 2026.

Significant Changes to Existing Law

• Amends Section 2713(a) of the Public Health Service Act (part of the Affordable Care Act's preventive services mandate) by adding a new category (E) specifically for prostate cancer screenings in high-risk men. Previously, preventive coverage focused on general USPSTF "A" or "B" rated services, immunizations, and certain screenings for women and children, but lacked explicit no-cost provisions tailored to high-risk men for prostate cancer.
• Introduces a targeted definition of "family history" to guide eligibility, which was not previously specified in federal law for this purpose.
• Builds on but does not alter the core framework of no-cost preventive care established in 2010, ensuring consistency while expanding equity for men's health.

Potential Impacts

• On Citizens: High-risk men (especially African-American men and those with family history) may benefit from earlier screenings, potentially increasing survival rates from near 100% for early-stage detection to reducing the 37% survival rate for late-stage cases. This could lower overall treatment costs by preventing advanced disease, which currently burdens the healthcare system with hundreds of millions in extra annual expenses.
• On Government Agencies: Agencies like the Centers for Disease Control and Prevention and Health Resources and Services Administration may see indirect effects through increased data on screening uptake and health outcomes, supporting ongoing research priorities identified by the USPSTF (e.g., studying earlier screenings for African-American men).
• On Health Insurers and Plans: Insurers must absorb screening costs without passing them to patients, potentially shifting short-term expenses but yielding long-term savings from fewer advanced treatments. No direct impact on international relations is anticipated, as this is a domestic health policy.

Main Stakeholders Affected

• High-Risk Men: Primary beneficiaries, including over 3.3 million men living with prostate cancer diagnoses, with disproportionate effects on African-American men (1 in 6 lifetime risk) and those with family history (over twice the risk).
• Health Insurance Issuers and Group Health Plans: Required to implement and fund the no-cost coverage, affecting employers offering group plans and individuals in the commercial market.
• Healthcare Providers: Urologists, oncologists, and primary care doctors may see increased demand for screenings, aiding in early intervention.
• Patient Advocacy Groups and Medical Societies: Organizations focused on cancer prevention (e.g., those recommending earlier discussions for high-risk groups) gain support for their guidelines.
• Broader Public Health Community: Includes federal agencies promoting research on health disparities, potentially reducing national prostate cancer mortality (estimated 35,700 deaths in 2025).

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens the Affordable Care Act's preventive care framework by addressing gaps in men's health equity, without conflicting with USPSTF authority. The "rule of construction" clause preserves flexibility for plans, avoiding overly broad mandates that could face legal challenges.
• Constitutional: No apparent issues, as it regulates interstate commerce in health insurance (a established federal power) and promotes general welfare through public health measures.
• Political: Highlights racial and socioeconomic health disparities, potentially advancing bipartisan efforts on preventive care and cancer research. It responds to calls from medical societies for targeted screenings, but could spark debates on expanding similar no-cost mandates to other conditions, influencing future healthcare policy.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Dunn, Neal P. [R-FL-2]

Cosponsors (36)

Rep. Clarke, Yvette D. [D-NY-9], Rep. Murphy, Gregory F. [R-NC-3], Rep. Carter, Troy A. [D-LA-2], Rep. Wasserman Schultz, Debbie [D-FL-25], Rep. McCollum, Betty [D-MN-4], Rep. Carey, Mike [R-OH-15], Rep. Ezell, Mike [R-MS-4], Rep. Miller, Max L. [R-OH-7], Rep. Tlaib, Rashida [D-MI-12], Rep. Chu, Judy [D-CA-28], Rep. Connolly, Gerald E. [D-VA-11], Rep. McClellan, Jennifer L. [D-VA-4], Rep. Davids, Sharice [D-KS-3], Rep. McClain Delaney, April [D-MD-6], Rep. Vindman, Eugene [D-VA-7], Rep. Mrvan, Frank J. [D-IN-1], Rep. Soto, Darren [D-FL-9], Rep. Lieu, Ted [D-CA-36], Rep. Cohen, Steve [D-TN-9], Rep. Ansari, Yassamin [D-AZ-3], Rep. Joyce, John [R-PA-13], Rep. Thompson, Bennie G. [D-MS-2], Rep. Scott, David [D-GA-13], Rep. Bilirakis, Gus M. [R-FL-12], Rep. Sherrill, Mikie [D-NJ-11], Rep. Davis, Donald G. [D-NC-1], Rep. Adams, Alma S. [D-NC-12], Rep. Veasey, Marc A. [D-TX-33], Rep. Balderson, Troy [R-OH-12], Rep. Lee, Susie [D-NV-3], Rep. Pappas, Chris [D-NH-1], Rep. Riley, Josh [D-NY-19], Rep. Peters, Scott H. [D-CA-50], Rep. Sykes, Emilia Strong [D-OH-13], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Pingree, Chellie [D-ME-1]

Recent Actions

• 2025-02-13: Referred to the House Committee on Energy and Commerce.
• 2025-02-13: Introduced in House
• 2025-02-13: Introduced in House

Bill Versions

• Prostate-Specific Antigen Screening for High-risk Insured Men Act — issued 2025-02-13 — PDF (7 pages)