US Federal 2025-2026 Regular Session

US Federal House Bill HB5813

Introduced
10/24/25  

Caption

Women’s Health and Cancer Rights Modernization Act of 2025

Impact

The bill significantly amends existing healthcare regulations by explicitly outlining the coverage requirements related to breast cancer care. Under this act, patients receiving treatment for breast cancer are guaranteed coverage for reconstruction procedures and the associated medical care. This includes extirpation of diseased breast tissue, various types of reconstructive surgeries, and related complications such as lymphedema treatment. The legislation aims to alleviate the financial burden on patients and enhance their access to essential medical services necessary for recovery and quality of life.

Summary

House Bill 5813, known as the Women’s Health and Cancer Rights Modernization Act of 2025, aims to enhance coverage requirements for breast or chest wall reconstruction in connection with breast cancer treatment. This bill mandates that group health plans and health insurance issuers provide comprehensive coverage of various reconstruction modalities, including implant-based and tissue-based reconstruction. It specifically ensures that options like immediate or delayed reconstruction, as well as custom-fabricated breast prostheses, are covered for patients who opt for reconstruction post-breast cancer treatment.

Contention

Despite its supportive goal for women's health, the bill may face scrutiny regarding the terms and conditions under which the coverage is provided. Critics might raise concerns about ensuring that all health plans can comply with these new coverage requirements, as well as the financial implications for insurers. Moreover, there could also be additional debates around the provision that prohibits plans from denying coverage solely to avoid these new regulations. This could lead to contentious discussions about reimbursement models and state laws that govern insurance coverage.

Notable_points

One key aspect of HB5813 is its emphasis on maintaining compliance with existing state laws that require similar coverage, thus preserving state-level regulations while setting new federal standards. The bill also calls for a report to be generated after enactment, evaluating the accessibility of breast reconstruction services, ensuring that barriers in care are identified and addressed effectively.

Companion Bills

No companion bills found.

Previously Filed As

US HB3037

Access to Breast Cancer Diagnosis Act of 2025

US SB1500

Access to Breast Cancer Diagnosis Act of 2025

US HB7905

Diabetes Foot Health Access and Modernization Act of 2026

US SB106

Chiropractic Medicare Coverage Modernization Act of 2025

US HB7227

Mental Health and MAMA Act of 2026 Mental Health and Making Access More Affordable Act of 2026

US HB539

Chiropractic Medicare Coverage Modernization Act of 2025

US HB4101

Cancer Drug Parity Act of 2025

US SB4070

Diabetes Foot Health Access and Modernization Act of 2026

US SB3698

Mental Health and MAMA Act of 2026 Mental Health and Making Access More Affordable Act of 2026

US HB5456

NWR Modernization Act of 2025 NOAA Weather Radio Modernization Act of 2025

Similar Bills

CA SB1352

Property taxation: newly constructed: reconstructed property.

CA AB245

Property taxation: application of base year value: disaster relief.

CA AB2385

Local reconstruction agencies.

CA AB1253

Property taxation: newly constructed property: reconstruction of damaged or destroyed property.

MD SB283

Creation of a State Debt – Maryland Consolidated Capital Bond Loan of 2026, and the Maryland Consolidated Capital Bond Loans of 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023, 2024, and 2025

OR SB1137

Relating to autologous breast reconstruction.

IN HB1373

Breast reconstruction coverage.