Increasing Access to Lung Cancer Screening Act
- Bill Number
- H.R. 6178
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-11-20: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-07-07T08:05:52Z
AI-Generated Summary
Purpose of the Legislation
The "Increasing Access to Lung Cancer Screening Act" (H.R. 6178) aims to improve early detection of lung cancer and support tobacco cessation by mandating coverage for preventive screenings and treatments across major U.S. health programs. It removes financial and administrative barriers, such as cost-sharing (out-of-pocket fees) and prior authorization (pre-approval requirements), to make these services more accessible, particularly for high-risk individuals like current or former heavy smokers.
Key Provisions
- Medicaid Coverage for Lung Cancer Screening (Section 2): Requires states to cover annual low-dose CT scans for lung cancer screening for eligible individuals recommended by U.S. Preventive Services Task Force (USPSTF) guidelines (e.g., adults aged 50-80 with a 20-pack-year smoking history who currently smoke or quit within the last 15 years). No cost-sharing or prior authorization is allowed. This applies to Medicaid managed care plans.
- Expanded Medicaid Coverage for Tobacco Cessation (Section 3): Extends mandatory coverage for counseling sessions and medications (pharmacotherapy, like nicotine replacement) to all Medicaid enrollees who use tobacco, not just pregnant women. No cost-sharing or prior authorization required. Applies to managed care plans.
- Medicare and Private Insurance Changes (Section 4): Prohibits prior authorization for USPSTF-recommended annual lung cancer screenings under Medicare Part B (outpatient services) and Medicare Advantage plans. For group and individual health insurance plans, issuers cannot require prior authorization for these screenings.
- Education and Outreach Campaign (Section 5): Directs the Secretary of Health and Human Services (HHS) to launch a public awareness campaign, in consultation with patient and advocacy groups, to educate high-risk individuals and healthcare providers about lung cancer screening benefits and eligibility. Authorizes $10 million annually from fiscal years 2026 through 2030 for implementation via contracts, grants, or direct efforts.
- Government Accountability Office (GAO) Report (Section 6): Requires the GAO to submit a report to Congress within one year of enactment analyzing lung cancer diagnosis and screening demographics. It must identify underserved groups (e.g., firefighters, veterans, women under 50) not covered by current guidelines and recommend federal actions to improve screening access.
Significant Changes to Existing Law
- Amends Title XIX of the Social Security Act (Medicaid) to add lung cancer screening as a mandatory benefit under state plans and expand tobacco cessation services from pregnant women to all enrollees, removing prior limits and barriers.
- Modifies Medicare (Title XVIII) by adding a new subsection to prohibit prior authorization for screenings, extending this to Medicare Advantage plans.
- Updates the Public Health Service Act (Section 2713) to bar prior authorization in private insurance, aligning with Affordable Care Act preventive service rules but specifically targeting lung cancer screenings.
- Effective dates are January 1, 2026, for most changes, with flexibility for states needing legislative approval to comply (delaying penalties until after their next legislative session).
Potential Impacts
- On Government Agencies: HHS and the Centers for Medicare & Medicaid Services (CMS) will oversee implementation, including guideline alignment and outreach funding, potentially increasing administrative workload. States may face higher Medicaid costs but could see long-term savings from early cancer detection. The GAO report could influence future policy.
- On Citizens: High-risk individuals (e.g., smokers, low-income, elderly) gain barrier-free access to screenings and cessation support, potentially leading to earlier diagnoses, better health outcomes, and reduced mortality from lung cancer (the leading cause of cancer deaths). However, it may slightly raise premiums or taxes to cover expanded benefits.
- On International Relations: No direct impacts, as the bill focuses on domestic health policy.
Main Stakeholders Affected
- Medicaid and Medicare Beneficiaries: Primarily low-income individuals, seniors, and disabled people at risk for lung cancer or tobacco use, who benefit from no-cost preventive care.
- Healthcare Providers and Insurers: Doctors, screening facilities, and managed care organizations must provide services without delays; private insurers face new coverage mandates.
- State Governments: Responsible for updating Medicaid plans, with potential budget strains but federal matching funds for costs.
- Advocacy and Patient Groups: Involved in outreach; groups like lung cancer foundations gain tools to promote awareness.
- Tobacco Users and High-Risk Populations: Smokers, former smokers, veterans, firefighters, and others underserved by current guidelines, who may see improved access.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens preventive care mandates under the Affordable Care Act by codifying USPSTF recommendations into law, reducing disputes over coverage denials. No prior authorization aligns with evidence-based medicine but could limit insurer flexibility in cost control.
- Constitutional: No apparent challenges; it involves federal spending on public health (Congress's enumerated powers) and does not infringe on state rights beyond Medicaid conditions, which are standard.
- Political: Promotes bipartisan public health goals (introduced by Democrats and Republicans), but may spark debates on federal overreach into state Medicaid programs or insurance markets. The outreach funding and GAO report could drive future expansions, emphasizing equity for underserved groups like veterans.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (7)
Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Wasserman Schultz, Debbie [D-FL-25], Rep. Lawler, Michael [R-NY-17], Rep. Gottheimer, Josh [D-NJ-5], Rep. Salinas, Andrea [D-OR-6], Rep. McIver, LaMonica [D-NJ-10], Rep. Kennedy, Timothy M. [D-NY-26]
Recent Actions
- 2025-11-20: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-11-20: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-11-20: Introduced in House
- 2025-11-20: Introduced in House
Bill Versions
- Increasing Access to Lung Cancer Screening Act — issued 2025-11-20 — PDF (12 pages)