Pennsylvania amends insurance law to require annual mammogram coverage for individuals over 40

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House Bill 433, introduced in the Pennsylvania Legislature on April 8, 2025, aims to enhance health insurance coverage for mammographic examinations. The bill amends Section 632 of the Insurance Company Law of 1921, mandating that all health insurance policies offered, issued, or renewed in Pennsylvania must provide coverage for annual mammograms for individuals aged 40 and older. Additionally, it stipulates that individuals under 40 may receive coverage for mammograms based on a physician's recommendation.

Key provisions of the bill include the requirement for insurers to cover all costs associated with these screenings, ensuring that financial barriers do not prevent individuals from accessing necessary preventive care. The legislation also mandates that insurers verify the licensing of mammography service providers before payment is made, aligning with the Mammography Quality Assurance Act.

The introduction of House Bill 433 has sparked discussions among lawmakers and health advocates, with supporters emphasizing the importance of early detection in reducing breast cancer mortality rates. Critics, however, have raised concerns about the potential financial implications for insurance providers and the healthcare system, particularly regarding the costs associated with increased screening.

The bill's passage could have significant social implications, as it aims to improve access to vital health services for women and individuals at risk of breast cancer. By ensuring comprehensive coverage for mammograms, the legislation seeks to promote preventive healthcare and potentially reduce long-term healthcare costs associated with late-stage cancer treatment.

As House Bill 433 moves through the legislative process, its supporters are optimistic about its potential to enhance women's health in Pennsylvania, while opponents continue to voice their concerns regarding the economic impact on insurance providers. The outcome of this bill could set a precedent for similar health coverage initiatives in other states.

Converted from House Bill 433 bill
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