119-hr4543

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4543 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 4543

 To amend title XIX of the Social Security Act to require coverage for 
 certain individual with breast or cervical cancer under the Medicaid 
 program.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 July 17, 2025

 Ms. Waters (for herself, Ms. Garcia of Texas, Ms. Norton, Ms. 
Velazquez, Ms. Wasserman Schultz, Mrs. Dingell, Ms. Clarke of New York, 
 Mr. Fields, Mr. Johnson of Georgia, Ms. Tlaib, Mr. Thompson of 
 Mississippi, Ms. Sewell, Mr. Gottheimer, Mrs. Watson Coleman, Mr. 
Thanedar, Ms. Lee of Pennsylvania, Mr. Latimer, Ms. Wilson of Florida, 
Mr. Veasey, Mr. Cohen, Mr. Lynch, Mrs. McIver, Mr. Garcia of Illinois, 
 Mrs. Cherfilus-McCormick, Ms. Moore of Wisconsin, and Mr. Costa) 
 introduced the following bill; which was referred to the Committee on 
 Energy and Commerce

_______________________________________________________________________

 A BILL

 To amend title XIX of the Social Security Act to require coverage for 
 certain individual with breast or cervical cancer under the Medicaid 
 program.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Medicaid Breast Cancer Access to 
Treatment Act''.

SEC. 2. REQUIRING MEDICAID COVERAGE FOR CERTAIN INDIVIDUALS WITH BREAST 
 OR CERVICAL CANCER UNDER THE MEDICAID PROGRAM.

    (a) In General.--

Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended--

    (1) in subsection

    (a)

    (10) --
        (A) in subparagraph
        (A) --
            (i) in the matter preceding clause
            (i) , by 
 striking ``and

    (30) '' and inserting ``

    (30) , and

    (32) '';
            (ii) in clause
            (i) --
            (I) in subclause
            (VIII) , by 
 striking ``or'' at the end;
            (II) in subclause
            (IX) , by adding 
 ``or'' at the end; and
            (III) by adding at the end the 
 following new subclause:
 ``
            (X) who are described in subsection

    (aa) (relating to certain breast or cervical cancer 
 patients);''; and
            (iii) in clause
            (ii) , by striking subclause
            (XVIII) ; and
        (B) in the matter at the end, in subdivision
            (XIV) , 
 by striking ``subparagraph
        (A) (10)
            (ii) 
            (XVIII) '' and 
 inserting ``subparagraph
        (A) (10)
            (i) 
            (X) ''; and

    (2) in subsection

    (aa) --
        (A) by striking paragraphs

    (1) and

    (2) ;
        (B) by redesignating paragraphs

    (3) and

    (4) as 
 paragraphs

    (1) and

    (2) , respectively; and
            (C) in paragraph

    (2) , as so redesignated, by 
 inserting ``as in effect on the day before the date of 
 the enactment of the Patient Protection and Affordable 
 Care Act,'' after ``(42 U.S.C. 300gg
            (c) ),''.

    (b) Inclusion of Breast Reconstruction as Medical Assistance.--

Section 1905

    (a) of the Social Security Act (42 U.S.C. 1396d

    (a) ) is 
amended--

    (1) in paragraph

    (31) , by striking ``and'' at the end;

    (2) by redesignating paragraph

    (32) as paragraph

    (33) ; and

    (3) by inserting after paragraph

    (31) the following new 
 paragraph:
 ``

    (32) breast reconstruction following a medically 
 necessary mastectomy; and''.
            (c) Conforming Amendments.--

    (1) FMAP.--

Section 1905

    (b)

    (4) of the Social Security Act 
 (42 U.S.C. 1396d

    (b)

    (4) ) is amended by striking ``

section 1902

    (a)

    (10)
        (A)
            (ii) 
            (XVIII) '' and inserting ``

section 1902

    (a)

    (10)
        (A)
            (i) 
            (X) ''.

    (2) Cost sharing.--
        (A) In general.--Subsections

    (a)

    (2) and

    (b)

    (2) of 
 

section 1916 of the Social Security Act (42 U.S.C. 
 1396o) are each amended--
            (i) in subparagraph
            (I) , by striking ``or'' 
 at the end;
            (ii) in subparagraph
        (J) , by striking ``; 
 and'' at the end and inserting ``, or''; and
            (iii) by adding at the end the following 
 new subparagraph:
 ``
        (K) items and services furnished to individuals described 
 in 

section 1902

    (aa) ; and''.
        (B) Alternative cost sharing.--

Section 1916A

    (b)

    (3) of the Social Security Act (42 U.S.C. 1396o-1

    (b)

    (3) ) is 
 amended--
            (i) in subparagraph
        (A)
            (v) , by striking 
 ``1902

    (a)

    (10)
        (A)
            (ii) 
            (XVIII) '' and inserting 
 ``1902

    (a)

    (10)
        (A)
            (i) 
            (X) ''; and
            (ii) in subparagraph
        (B)
            (viii) , by striking 
 ``1902

    (a)

    (10)
        (A)
            (ii) 
            (XVIII) '' and inserting 
 ``1902

    (a)

    (10)
        (A)
            (i) 
            (X) ''.
            (d) Effective Date.--The amendments made by this section shall 
apply beginning 1 year after the date of the enactment of this Act.
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