PSA Screening for HIM Act

Bill Number

S. 297

Origin Chamber

Senate

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2026-03-19: Committee on Health, Education, Labor, and Pensions. Hearings held.

Last Updated

2026-03-20T11:03:17Z

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 among high-risk men by mandating no-cost coverage for screenings under group and individual health insurance plans. It addresses health disparities, particularly for African-American men and those with a family history, by reducing financial barriers to preventive care.

Key Provisions

• Mandated Coverage: Amends Section 2713(a) of the Public Health Service Act (part of the Affordable Care Act) to require group health plans and health insurance issuers to cover evidence-based prostate cancer screenings (such as PSA tests) for men aged 40 and older who are at high risk, without any cost-sharing (e.g., deductibles, copays, or coinsurance).
• Definition of High-Risk Men: Includes African-American men and 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 risk factor for prostate cancer, or a related cancer increasing prostate cancer risk.
• Congressional Findings: Outlines statistics on prostate cancer prevalence, mortality (e.g., second leading cause of cancer death in men, with 1 in 8 men diagnosed lifetime), survival rates (nearly 100% for early-stage vs. 37% for late-stage), disparities (African-American men 70% more likely to be diagnosed and 2.1 times more likely to die), and the high cost of treating advanced vs. early-stage cancer.
• Additional Clarifications:
• Specifies that current U.S. Preventive Services Task Force (USPSTF) recommendations on breast cancer screening (post-2009) remain in effect, unaffected by this bill.
• Allows plans to offer additional coverage beyond USPSTF recommendations and does not require denying non-recommended services.
• Effective Date: Applies to plan years beginning on or after January 1, 2025.

Significant Changes to Existing Law

• Expands the list of preventive health services under the Affordable Care Act (ACA) that must be covered without cost-sharing by adding prostate cancer screenings for high-risk men as a new category (subparagraph E under Section 2713(a)).
• Redesignates existing paragraphs in the law for structural clarity and inserts the new requirement after current preventive services (e.g., immunizations, screenings for other conditions).
• Introduces a specific definition for "family history" not previously detailed in the statute, targeting underserved groups based on USPSTF research gaps.

Potential Impacts

• On Citizens: High-risk men (especially African-American men and those with family history) gain access to free annual or recommended screenings, potentially increasing early detection rates, improving survival (from 37% late-stage to near 100% early-stage), and reducing overall healthcare costs by preventing advanced cancer treatment (estimated hundreds of millions in annual savings).
• On Government Agencies: The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) may need to update regulations and guidance to enforce compliance, monitor implementation, and address USPSTF research priorities on screening disparities.
• On Health Insurers and Plans: Increases mandatory no-cost benefits, potentially raising premiums slightly but offset by long-term savings from early intervention; no direct impact on international relations.
• Broader Health System: Encourages earlier screening discussions per major medical societies, minimizes barriers for asymptomatic detection, and highlights racial health inequities.

Main Stakeholders Affected

• High-Risk Men: Primary beneficiaries, including over 3.3 million men living with prostate cancer diagnoses and those at elevated risk (e.g., 1 in 6 African-American men).
• Health Insurers and Group Health Plans: Required to provide coverage without cost-sharing, affecting private insurers, employer-sponsored plans, and self-insured groups.
• Employers: Those offering group health plans must ensure compliance, potentially influencing benefit designs.
• Healthcare Providers: Urologists, oncologists, and primary care doctors benefit from increased screening uptake, aiding early intervention.
• Medical Organizations: Groups like the American Cancer Society and USPSTF may see alignment with their recommendations, supporting ongoing research.

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens ACA preventive care mandates by filling a research-identified gap in USPSTF guidelines, without overriding them; the "rule of construction" preserves flexibility for plans, avoiding conflicts with existing federal requirements under ERISA (Employee Retirement Income Security Act) for employer plans.
• Constitutional: No apparent challenges; aligns with Congress's authority to regulate interstate commerce in health insurance and promote public health, similar to other ACA expansions.
• Political: Bipartisan introduction (by Senators Boozman and Booker) signals cross-party support for addressing cancer disparities; could influence future preventive care bills by setting a precedent for targeting high-risk populations, though implementation may face debates on costs and equity in non-group markets (e.g., Medicaid, Medicare not directly amended).

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

Sponsor

Sen. Boozman, John [R-AR]

Cosponsors (6)

Sen. Booker, Cory A. [D-NJ], Sen. Padilla, Alex [D-CA], Sen. Warnock, Raphael G. [D-GA], Sen. Cantwell, Maria [D-WA], Sen. Shaheen, Jeanne [D-NH], Sen. Coons, Christopher A. [D-DE]

Recent Actions

• 2026-03-19: Committee on Health, Education, Labor, and Pensions. Hearings held.
• 2025-01-29: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
• 2025-01-29: Introduced in Senate

Bill Versions

• Prostate-Specific Antigen Screening for High-risk Insured Men Act — issued 2025-01-29 — PDF (7 pages)