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House passes bill requiring insurers to cover scalp‑cooling for chemotherapy patients
Summary
On Feb. 26, 2026 the Maryland House approved House Bill 393, requiring commercial insurers to cover scalp‑cooling systems used by patients undergoing chemotherapy. Lawmakers delivering personal testimony cited dignity and lived experience; the chamber recorded a 129‑7 vote after an actuarial estimate put the cost at about 1 cent per member per month.
The Maryland House of Delegates on Feb. 26 passed House Bill 393, a measure requiring commercial health insurers to cover scalp‑cooling systems for patients receiving chemotherapy, by a roll‑call vote of 129 yeas to 7 nays.
Supporters emphasized patient dignity and the emotional toll of chemotherapy hair loss. "Breast cancer sucks," a delegate from the Eastern Shore said during floor remarks, describing the trauma patients and families endure and urging a "green" vote to preserve dignity. Several lawmakers gave personal accounts of family members or constituents who lost hair during treatment to explain why the benefit matters.
The bill’s proponents pointed to a legislative actuary’s estimate reported on the floor by the vice chair of the health committee that the benefit would cost roughly "1 cent per month per member" for commercial payers. "We felt that this benefit was worth 12 cents a year for everyone who's paying for commercial insurance," the vice chair said, presenting the actuarial finding as evidence the mandate would be affordable.
Opponents warned that adding mandates can raise premiums and make coverage less affordable overall. One delegate who identified as a person living with type 1 diabetes recounted long personal experience with health costs and said he would vote no on principle because of concerns about growing insurance mandates and their effect on premiums.
After roughly an hour of floor statements and several members rising to explain their votes, the clerk took the roll. The final tally was 129 in favor and 7 against. The bill was declared passed and will proceed toward enrollment and transmittal to the Senate or the next procedural step required by state rules.
What it does and what remains unclear: HB 393, as described on the floor, requires commercial payers (HMOs and large group insurers) to cover scalp‑cooling treatments; the debate clarified that the requirement is for commercial plans and not a Medicaid expansion. The bill’s fiscal impact cited on the floor was limited to the estimated commercial cost; specifics about implementation (eligible devices, prior authorization, provider networks) will emerge in implementing guidance and insurer filings.
Next steps: Following enrollment, the measure will move through the formal engrossment and transmittal process required of passed House bills. Advocates said they would press for clear implementation directives so patients and providers can access the benefit promptly.
