II 

118TH CONGRESS 

2D SESSION S. 5428 

To provide women with increased access to preventive and life-saving cancer 

screening. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 4, 2024 

Mrs. MURRAY (for herself, Mrs. SHAHEEN, Mr. BLUMENTHAL, Mr. BOOKER, 

Mr. VAN HOLLEN, Mrs. GILLIBRAND, Ms. BALDWIN, Ms. KLOBUCHAR, 

Ms. ROSEN, Mr. WYDEN, Ms. STABENOW, Mr. MERKLEY, and Mr. 

WELCH) introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide women with increased access to preventive and 

life-saving cancer screening. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Jeanette Acosta Invest 

5 in Women’s Health Act of 2024’’. 

6 SEC. 2. PURPOSE. 

7 It is the purpose of this Act to provide women with 

8 increased access to preventive and life-saving cancer 

9 screening (including clinical breast exams and breast, cerVerDate Sep 11 2014 02:27 Dec 11, 2024 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S5428.IS S5428

kjohnson on DSK7ZCZBW3PROD with $$_JOB
2 

•S 5428 IS

1 vical, ovarian, uterine, vaginal, and vulvar cancer screen2 ing), as well as access to appropriate care and early detec3 tion (including via diagnostic testing and treatment and 

4 provider education and awareness of best clinical prac5 tices), provided by leading women’s health care providers 

6 who— 

7 (1) serve populations most at risk of lacking ac8 cess to preventive care; and 

9 (2) play an outsized role in the prevention and 

10 detection of cancer in order to serve the goal of in11 creasing access to quality health screenings, care, 

12 and services, reducing health care disparities and 

13 mortality rates among low-income women and 

14 women of color, decreasing health care spending, 

15 and expanding health literacy, access, and education 

16 about the benefits of regular preventive cancer 

17 screening for women. 

18 SEC. 3. FINDINGS. 

19 Congress finds as follows: 

20 (1) Breast cancer is the leading cause of cancer 

21 death in women under the age of 54, and the Amer22 ican Cancer Society recommends that women in 

23 their 20s and 30s have a clinical breast exam at 

24 least every 3 years. 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
3 

•S 5428 IS

1 (2) Ovarian cancer causes more deaths than 

2 any other cancer of the female reproductive system, 

3 but it accounts for only about 3 percent of all can4 cers in women. 

5 (3) The cancers that most frequently impact 

6 women include breast, uterine, ovarian, and cervical 

7 cancer, and there were 355,937 new cases of these 

8 cancers in 2019. 

9 (4) Rates of incidence and death for gynecologic 

10 cancers by race and ethnicity show that, while for 

11 some cancers, like ovarian cancer, the rates of inci12 dence and death are similar among all races, for 

13 other cancers, like cervical cancer, women of color 

14 have disproportionate incidence and mortality rates. 

15 While the incidence of uterine cancer is similar for 

16 White women and women of color, rates of death for 

17 uterine cancer are 2 times higher for Black women 

18 than for White women. 

19 (5) Cervical cancer incidence and mortality 

20 rates are higher for women living in rural and un21 derserved regions in the United States. Women liv22 ing in such areas face unique barriers in accessing 

23 reproductive health care services to prevent and 

24 treat cervical cancer, including a lack of practicing 

25 gynecologists in rural areas and challenges around 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
4 

•S 5428 IS

1 transportation to preventive and follow-up appoint2 ments. 

3 (6) Prevention and cancer screening are the 

4 best approaches to protecting women from cancer 

5 and ensuring early detection and life-saving treat6 ment. Many deaths from breast and cervical cancers 

7 could be avoided if cancer screening rates and diag8 nostic care and services increased among women at 

9 risk. Deaths from such cancers occur disproportion10 ately among women who are uninsured or under11 insured. 

12 (7) Due to enhanced screening, cervical cancer 

13 is now a much more preventable and treatable can14 cer. It is also highly curable when found and treated 

15 early. 

16 (8) Increased access to education; information, 

17 including information on the human papillomavirus 

18 vaccine; and preventive cancer screenings, resulting 

19 in timely and adequate treatment, increase women’s 

20 ability to survive cancer. 

21 (9) While more than 20 percent of cases of cer22 vical cancer are found in women over the age of 65, 

23 it becomes less likely that women are tested for cer24 vical cancer ever or within the previous 5 years as 

25 their age increases. 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
5 

•S 5428 IS

1 (10) Women’s health care providers that are 

2 primarily engaged in family planning services, such 

3 as Planned Parenthood health centers, provide nec4 essary screening tests, education, and information to 

5 women, especially women of color who face the high6 est risks of breast cancer and other gynecologic can7 cers. 

8 (11) Access to preventive gynecological screen9 ing is also critical for transgender men who have 

10 comparable rates of susceptibility to cervical cancer 

11 as cisgender women, but often have less access to 

12 preventive screenings. 

13 (12) Discrimination and racism in health care 

14 continues to contribute to disparate rates of gyneco15 logical cancer in non-White women. Black, Indige16 nous, and other women of color die at higher rates 

17 from cervical cancer than White women, even though 

18 fewer women overall die from cervical cancer. 

19 (13) Black women with endometrial cancer 

20 often receive surgery less often than White women 

21 and are more likely to be diagnosed at an advanced 

22 stage of the disease, contributing to disparities in 

23 mortality in Black women. 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
6 

•S 5428 IS

1 SEC. 4. STRENGTHENING ACCESS TO CANCER SCREENING 

2 FOR WOMEN. 

3 Part B of title III of the Public Health Service Act 

4 (42 U.S.C. 243 et seq.) is amended by inserting after sec5 tion 317P the following: 

6 ‘‘SEC. 317P–1. GRANTS FOR WOMEN’S HEALTH CARE PRO7 VIDERS. 

8 ‘‘(a) IN GENERAL.—The Secretary is authorized to 

9 make grants and to enter into contracts with public or 

10 nonprofit private entities to expand preventive health serv11 ices, including the cancer screening services required to 

12 be covered by group health plans and health insurance 

13 coverage pursuant to section 2713(a)(4). In awarding 

14 such grants, the Secretary shall seek to increase access 

15 to critical, life-saving cancer screening, cervical cytology 

16 (commonly referred to as ‘Pap tests’), human 

17 papillomavirus tests, human papillomavirus and Pap 

18 cotests, human papillomavirus vaccinations, and diag19 nostic tests for women with cancer symptoms, particularly 

20 women of color. 

21 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

22 is authorized to be appropriated to carry out this section, 

23 $20,000,000 for each of fiscal years 2025 through 2027.’’. 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
7 

•S 5428 IS

1 SEC. 5. EXPANDING CANCER SCREENING PROVIDER TRAIN2 ING. 

3 Part B of title III of the Public Health Service Act 

4 (42 U.S.C. 243 et seq.), as amended by section 4, is fur5 ther amended by inserting after section 317P–1 the fol6 lowing: 

7 ‘‘SEC. 317P–2. WOMEN’S HEALTH CARE PROVIDERS DEM8 ONSTRATION TRAINING PROJECT. 

9 ‘‘(a) ESTABLISHMENT OF PROGRAM.—The Secretary 

10 shall establish a demonstration program to award 3-year 

11 grants to eligible entities for the training of physicians, 

12 nurse practitioners, physician assistants, and other health 

13 care providers related to life-saving breast and gynecologic 

14 cancer screening for women, including appropriate follow15 up care and screening for abnormal results. 

16 ‘‘(b) PURPOSE.—The purpose of the program under 

17 this section is to enable each grant recipient to— 

18 ‘‘(1) provide to licensed physicians, nurse prac19 titioners, physician assistants, and other health care 

20 providers, through clinical training, education, and 

21 practice, the most up-to-date clinical guidelines, re22 search, and recommendations adopted by the United 

23 States Preventive Services Task Force in the area of 

24 preventive cancer screening for breast and 

25 gynecologic cancers, including for women with dense 

26 breast tissue; 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
8 

•S 5428 IS

1 ‘‘(2) establish a model of training for physi2 cians, nurse practitioners, physician assistants, and 

3 other health care providers that specialize in wom4 en’s health care, with a specific focus on breast and 

5 gynecologic cancer screening and follow up care, that 

6 may be replicated nationwide; 

7 ‘‘(3) train physicians, nurse practitioners, phy8 sician assistants, and other health care providers to 

9 serve rural and underserved communities, low-in10 come communities, and communities of color in 

11 breast and gynecologic cancer screening and follow 

12 up care; and 

13 ‘‘(4) provide implicit bias, cultural competency, 

14 and patient-centered communication training cov15 ering the ways in which structural racism and dis16 crimination manifest within the medical field and 

17 perpetuate racial disparities in gynecologic cancer in18 cidence and mortality rates and how to communicate 

19 with patients through a knowledgeable and culturally 

20 empathetic lens. 

21 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

22 a grant under this section, an entity shall be— 

23 ‘‘(1) an entity that receives funding under sec24 tion 1001 or section 1003; 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
9 

•S 5428 IS

1 ‘‘(2) an essential community provider, as de2 fined in section 156.235 of title 45, Code of Federal 

3 Regulations (or any successor regulations), that is 

4 primarily engaged in family planning; 

5 ‘‘(3) an entity that furnishes items or services 

6 to individuals enrolled in a State Medicaid program 

7 or waiver of such a plan; or 

8 ‘‘(4) an entity that, at the time of application, 

9 provides cancer screening services under the Na10 tional Breast and Cervical Cancer Early Detection 

11 Program under title XV.’’. 

12 SEC. 6. STUDY AND REPORT TO CONGRESS ON INCREASED 

13 CANCER SCREENING FOR WOMEN. 

14 (a) IN GENERAL.—The Secretary of Health and 

15 Human Services (referred to in this section as the ‘‘Sec16 retary’’) shall— 

17 (1) conduct a study (and periodically update 

18 such study) on increased access to women’s preven19 tive life-saving cancer screenings across the United 

20 States; and 

21 (2) not later than 2 years after the date of en22 actment of this Act, and every 5 years thereafter, 

23 submit a report to Congress on such study. 

24 (b) CONTENTS.—The study and reports under sub25 section (a) shall include— 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
10 

•S 5428 IS

1 (1) an analysis of breast and gynecologic cancer 

2 rates among women across all 50 States, the Dis3 trict of Columbia, and the territories, including by 

4 geographic area, income, employment status, race, 

5 ethnicity, and status of insurance coverage; 

6 (2) an analysis of cancer screenings provided by 

7 women’s health care providers across all 50 States, 

8 the District of Columbia, and the territories, includ9 ing clinical breast exams, other screening for breast 

10 cancer, and screening for cervical cancer, ovarian 

11 cancer, and other gynecologic cancers; 

12 (3) with respect to women with disproportionate 

13 rates of gynecological cancers, or who are less likely 

14 to receive screenings and care, and broken down by 

15 categories of such women that include African-Amer16 ican women, Hispanic and Latina women, older 

17 women, uninsured and underinsured women, and 

18 women living in rural and underserved areas— 

19 (A) an analysis of the awareness, avail20 ability, and uptake of breast, cervical, ovarian, 

21 and other gynecological cancer screening op22 tions; 

23 (B) an analysis of how access to health 

24 care providers trained under the program de25 scribed in section 317P–2 of the Public Health 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
11 

•S 5428 IS

1 Service Act, as added by section 5, in compari2 son to other health care providers, increased 

3 early detection of cancer and quality of cancer 

4 care for such women; and 

5 (C) recommendations for increasing 

6 screening rates for such women who are less 

7 likely to be screened or treated for breast, cer8 vical, ovarian, and other gynecological cancers; 

9 (4) an analysis of how structural racism im10 pacts access to cancer screening services, correlates 

11 to the development of breast, cervical, ovarian, and 

12 other gynecological cancers, and exacerbates health 

13 care disparities for African-American, Hispanic and 

14 Latina women, and other women of color; 

15 (5) in consultation with the Comptroller Gen16 eral of the United States, estimated Federal savings 

17 achieved through early detection of breast and 

18 gynecologic cancers; 

19 (6) recommendations by the Secretary with re20 spect to the need for continued increased access to 

21 women’s health care providers, such as the entities 

22 described in section 317P–2(c) of the Public Health 

23 Service Act, as added by section 5, who provide pre24 ventive care, including life-saving cancer screenings; 

25 and 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
12 

•S 5428 IS

1 (7) an evaluation of the demonstration project 

2 on co-testing for human papillomavirus and cervical 

3 cancer under section 317P–3 of the Public Health 

4 Service Act, as added by section 7, including the re5 sults of the demonstration project and a rec6 ommendation on whether expansion of the co-testing 

7 model described in such section 317P–3 would be 

8 advised in order to promote early intervention, 

9 screening uptake, and reduce cervical cancer deaths 

10 and racial and ethnic disparities. 

11 SEC. 7. DEMONSTRATION PROJECT ON CO-TESTING FOR 

12 HUMAN PAPILLOMAVIRUS AND CERVICAL 

13 CANCER. 

14 Part B of title III of the Public Health Service Act 

15 (42 U.S.C. 243 et seq.), as amended by section 5, is fur16 ther amended by inserting after section 317P–2 the fol17 lowing: 

18 ‘‘SEC. 317P–3. DEMONSTRATION PROJECT ON CO-TESTING 

19 FOR HUMAN PAPILLOMAVIRUS AND CER20 VICAL CANCER. 

21 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

22 with the Director of the Centers for Disease Control and 

23 Prevention and the Administrator of the Health Resources 

24 and Services Administration, as appropriate, shall estab25 lish a 2-year demonstration project on increasing the cerVerDate Sep 11 2014 02:27 Dec 11, 2024 Jkt 059200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S5428.IS S5428

kjohnson on DSK7ZCZBW3PROD with $$_JOB
13 

•S 5428 IS

1 vical cancer screening co-testing of human papillomavirus 

2 and cervical cytology (commonly referred to as ‘Pap tests’) 

3 to develop models for increasing the rates of co-testing 

4 among women with disproportionate rates of cervical can5 cer, including African-American and Hispanic and Latina 

6 women. 

7 ‘‘(b) USE OF FUNDS.—Entities receiving an award 

8 under this section shall use such award to— 

9 ‘‘(1) increase access to co-testing of human 

10 papillomavirus testing and cervical cancer among pa11 tients with disproportionate rates of cervical cytol12 ogy, including African-American and Hispanic and 

13 Latina women; 

14 ‘‘(2) support culturally and linguistically appro15 priate delivery models to such patients, including 

16 through the provision of interpretation services; or 

17 ‘‘(3) provide other services to improve health 

18 outcomes with respect to such patients. 

19 ‘‘(c) PRIORITIZATION.—In making awards under this 

20 section, the Secretary shall give priority to eligible entities 

21 serving low-income, uninsured, or medically underserved 

22 populations (as defined in section 330(b)(3)) or popu23 lations with historically low rates of such co-testing, such 

24 as older women. 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
14 

•S 5428 IS

1 ‘‘(d) ELIGIBLE ENTITIES.—To be eligible to receive 

2 a grant under this section, an entity shall be an entity 

3 described in section 317P–2(c).’’. 

Æ 


kjohnson on DSK7ZCZBW3PROD with $$_JOB