The Virginia General Assembly convened on January 8, 2025, to introduce Senate Bill No. 1238, a legislative proposal aimed at amending the Code of Virginia to eliminate cost-sharing for breast examinations. The bill, patroned by Senator Durant, has been referred to the Committee on Commerce and Labor for further consideration.

Senate Bill 1238 seeks to ensure that individuals covered under individual or group accident and sickness insurance policies, as well as health maintenance organizations, will not face any cost-sharing—defined as coinsurance, copayment, or deductible—for diagnostic and supplemental breast examinations. This provision is intended to enhance access to necessary breast cancer screenings and evaluations, aligning with guidelines set forth by the National Comprehensive Cancer Network.

Key provisions of the bill specify that diagnostic breast examinations are medically necessary evaluations conducted when an abnormality is suspected or detected, while supplemental breast examinations are screenings based on personal or family medical history that may increase an individual's risk of breast cancer. By removing financial barriers, the bill aims to encourage more individuals to seek timely medical evaluations, potentially leading to earlier detection and treatment of breast cancer.

As the bill progresses through the legislative process, it may face debates regarding its financial implications for insurers and the healthcare system. Proponents argue that the long-term benefits of early detection and treatment of breast cancer will outweigh the costs, while opponents may raise concerns about the potential impact on insurance premiums and the overall healthcare market.

The introduction of Senate Bill 1238 reflects a growing recognition of the importance of preventive healthcare measures and the need to address disparities in access to essential medical services. If passed, the bill could significantly influence healthcare practices in Virginia, promoting a more proactive approach to breast cancer screening and potentially improving health outcomes for women across the Commonwealth. The Committee on Commerce and Labor is expected to review the bill in the coming weeks, with discussions likely to focus on its feasibility and broader implications for health insurance policies in Virginia.