Michigan 2025-2026 Regular Session

Michigan House Bill HB5199

Introduced
11/4/25  

Caption

Insurance: health insurers; age eligibility for coverage for annual breast cancer mammography examination; lower. Amends sec. 3406d of 1956 PA 218 (MCL 500.3406d).

Impact

The implications of HB 5199 are significant for both policyholders and healthcare providers. By mandating insurers to cover specific breast cancer-related services, the bill could potentially lead to improved early detection and treatment of breast cancer. Individuals aged 35 and above will be eligible for at least one screening mammography every five years, while those over 40 will be eligible for annual screenings. This could enhance access to necessary screenings and ensure that women receive timely care, reducing the burden of late-stage cancer diagnoses.

Summary

House Bill 5199 aims to amend existing insurance laws to enhance coverage related to breast cancer services in the state of Michigan. Specifically, the bill focuses on requiring health insurance policies to offer coverage for breast cancer diagnostic services, outpatient treatment services, and rehabilitative services. Under this bill, insurers must ensure that the coverage offered is subject to dollar limits, deductibles, and coinsurance provisions that are at least as favorable as those applied to physical illnesses. This change reflects a legislative effort to better support individuals battling breast cancer through comprehensive insurance provisions.

Contention

However, the bill is not without contention. Critics may raise concerns regarding the financial implications for insurers and the potential for increased healthcare costs as a result of mandated coverage. Insurers might argue that such requirements could lead to higher premiums for policyholders across the board. Furthermore, there may be debates on how such mandates could affect the balance between state regulations and the health insurance market's competitive nature. Proponents of the bill argue that the need for comprehensive cancer care outweighs the potential cost increases.

Notable_points

Overall, HB 5199 represents a step toward improving health outcomes for breast cancer patients in Michigan. Its focus on essential health benefits, in terms of early screening and comprehensive treatment options, illustrates a broader commitment to women's health issues. As legislative discussions continue, the bill’s progress will hinge on navigating the concerns of various stakeholders, including insurers, medical professionals, and patient advocates.

Companion Bills

No companion bills found.

Previously Filed As

MI HB5205

Insurance: health insurers; coverage for examinations and medications related to breast cancer; provide for. Amends sec. 3406d of 1956 PA 218 (MCL 500.3406d).

MI HB433

In casualty insurance, further providing for coverage for mammographic examinations and breast imaging.

MI SB88

In casualty insurance, repealing provisions relating to coverage for mammographic examinations and breast imaging and providing for coverage for mammographic examinations, magnetic resonance imaging and other forms of breast imaging.

MI HB4464

Insurance: health insurers; compliance with affordable care act coverage; modify. Amends secs. 3403, 3406z, 3406bb, 3406hh & 3406ii of 1956 PA 218 (MCL 500.3403 et seq.).

MI SB0135

Insurance: health insurers; compliance with affordable care act coverage; modify. Amends secs. 3403, 3406z, 3406bb & 3406ii of 1956 PA 218 (MCL 500.3403 et seq.).

MI SB296

Insurance Coverage for Breast Cancer Examinations

MI HB1389

Mammography screening; coverage for low-dose mammography screening; examinations; definition; effective date.

MI HB1389

Mammography screening; coverage for low-dose mammography screening; examinations; definition; effective date.

MI S1494

Insurance Coverage for Breast Cancer Screening

MI HB4740

Insurance: health insurers; required coverage for autism spectrum disorders; modify. Amends sec. 3406s of 1956 PA 218 (MCL 500.3406s).

Similar Bills

MI SB0136

Health: testing; notification of dense breast tissue; eliminate, and provide for other general amendments to the use of radiation machines. Amends secs. 13501, 13521, 13522 & 13523 of 1978 PA 368 (MCL 333.13501 et seq.) & repeals secs. 13524 & 13531 of 1978 PA 368 (MCL 333.13524 & 333.13531).

OH HB271

Enact Breast Examination and Screening Transformation (BEST) Act

TX SB1084

Relating to certain mammography reports providing required breast density information.

CA AB1570

Health care coverage: diagnostic imaging.

AR HB1429

To Increase Accessibility While Ensuring Quality For Certain Facilities Performing Mammography Services; And To Amend The Law Concerning The Quality Standards For Accreditation Of Facilities For Mammography.

MD HB1364

Public Health - Mammograms - Arterial Calcification Notice

AZ HB2561

Insurance; cost sharing; breast examinations

IN HB1112

Coverage for cancer screening.