Momentum builds as several states propose supplemental breast imaging legislation in 2026
Momentum appears to be building, with several states introducing supplemental breast imaging legislation in 2026.
Hawaii is among the latest, after state Rep. Lauren Matsuomto, a Republican representing the 38th District, introduced House Bill 2366 on Jan. 28. The legislation would require health insurers to cover medically necessary follow-up imaging, including MRIs and ultrasound, after abnormal screening mammograms. This comes after Alabama, Arizona, California, Rhode Island and South Carolina also have introduced similar legislation this year, while Pennsylvania passed its own in November.
Altogether, about 30 states have now enacted legislation related to supplemental breast imaging, according to women’s health lobbying group Susan G. Komen.
“Nobody should be forced to skip medical care that helps to detect breast cancer early because of the cost, yet thousands of Hawaiians are forced to make that decision every year,” Molly Guthrie, VP of policy and advocacy at Komen, said in a statement Feb. 2. “This bill will remove the financial barrier so that individuals can get the medically necessary breast imaging they need without having to endure financial burdens.”
The Affordable Care Act established that most insurance plans must cover screening mammograms for women age 40 and older at no cost. However, factors such as dense breasts or a genetic disposition to the disease may necessitate that women need additional follow-up imaging. But with gaps in insurance coverage, women are sometimes forced to pay anywhere from $234 out of pocket for an ultrasound up to over $1,000 for a breast MRI, according to a Komen-commissioned study. About 1 in 5 patients say they would forego recommended follow-up breast imaging if they had to pay a deductible, another analysis published in Radiology found.
Members of Congress have pushed a potential national fix to this issue, proposing the Find It Early Act and other similar alternatives, but these bills have failed to find passage. Absent action in Washington, numerous states have instead fought for local legislative remedies.
“Breast cancer can devastate lives, families and communities, but when it’s diagnosed early, people are given a fighting chance at a healthy future,” Hawaii state Rep. Matsumoto said in a statement. “This legislation will ensure that cost is never a barrier to early breast cancer detection. I look forward to working alongside my colleagues to advance H.B. 2366.”
More discussion on this issue
Advocates on this issue also recently discussed recent progress during the ACR-RBMA Practice Leadership Forum, held Jan. 30 to Feb. 1 in Dallas.
Rayus Radiology’s Kit Crancer and radiologist Amy K. Patel, MD, gave a legislative recap and forecasted what’s to come both locally and in Washington for 2026. Crancer, senior VP of public policy, noted that just a few years ago, only a “small handful of states” had passed legislation related to supplemental screening.
Fast forward to today, and 30-plus states, both red and blue, have now enacted bills and closed the coverage gap. He believes federal policymakers also are “increasingly looking to mirror these efforts” at the national level.
Patel, medical director of the Liberty Hospital Breast Care Center in Missouri, compared this year’s push to previous efforts to enact dense-breast notification legislation. Gradually, one state after another passed their own notification laws, eventually culminating in a federal mandate under the Mammography Quality Standards Act in September 2024.
“Momentum is building,” Patel said by email in response to the recent wave of state proposals in Hawaii and elsewhere. “The hope is that as more states pass this legislation, we can finally see the passage of some sort of federal version, such as the Find it Early Act,” she added later. “Until then, it’s on the states to act, and we are appreciative of the relationships we have throughout the House of Medicine and with organizations such as Susan G. Komen and the American Cancer Society, who currently share a unified mission with us to pass these critical pieces of legislation at the state level.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.