I 
119TH CONGRESS 
1ST SESSION H. R. 4543 
To amend title XIX of the Social Security Act to require coverage for 
certain individual with breast or cervical cancer under the Medicaid program. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 17, 2025 
Ms. WATERS
(for herself, Ms. GARCIA
of Texas, Ms. NORTON, Ms. 
VELA´ZQUEZ, Ms. WASSERMAN SCHULTZ, Mrs. DINGELL, Ms. CLARKE of 
New York, Mr. FIELDS, Mr. JOHNSON of Georgia, Ms. TLAIB, Mr. 
THOMPSON of Mississippi, Ms. SEWELL, Mr. GOTTHEIMER, Mrs. WAT-
SON COLEMAN, Mr. THANEDAR, Ms. LEE of Pennsylvania, Mr. LATIMER, 
Ms. WILSON of Florida, Mr. VEASEY, Mr. COHEN, Mr. LYNCH, Mrs. 
MCIVER, Mr. GARCI´A of Illinois, Mrs. CHERFILUS-MCCORMICK, Ms. 
MOORE of Wisconsin, and Mr. COSTA) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to require 
coverage for certain individual with breast or cervical 
cancer under the Medicaid program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicaid Breast Can-
cer Access to Treatment Act’’. 
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SEC. 2. REQUIRING MEDICAID COVERAGE FOR CERTAIN IN-
DIVIDUALS WITH BREAST OR CERVICAL CAN-
CER UNDER THE MEDICAID PROGRAM. 
(a) IN GENERAL.—Section 1902 of the Social Secu-
rity Act (42 U.S.C. 1396a) is amended— 
(1) in subsection (a)(10)— 
(A) in subparagraph (A)— 
(i) in the matter preceding clause (i), 
by striking ‘‘and (30)’’ and inserting 
‘‘(30), and (32)’’; 
(ii) in clause (i)— 
(I) in subclause (VIII), by strik-
ing ‘‘or’’ at the end; 
(II) in subclause (IX), by adding 
‘‘or’’ at the end; and 
(III) by adding at the end the 
following new subclause: 
‘‘(X) who are described in subsection 
(aa) (relating to certain breast or cervical 
cancer patients);’’; and 
(iii) in clause (ii), by striking sub-
clause (XVIII); and 
(B) in the matter at the end, in subdivision 
(XIV), 
by 
striking 
‘‘subparagraph 
(A)(10)(ii)(XVIII)’’ and inserting ‘‘subpara-
graph (A)(10)(i)(X)’’; and 
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(2) in subsection (aa)— 
(A) by striking paragraphs (1) and (2); 
(B) by redesignating paragraphs (3) and 
(4) as paragraphs (1) and (2), respectively; and 
(C) in paragraph (2), as so redesignated, 
by inserting ‘‘as in effect on the day before the 
date of the enactment of the Patient Protection 
and Affordable Care Act,’’ after ‘‘(42 U.S.C. 
300gg(c)),’’. 
(b) INCLUSION
OF BREAST RECONSTRUCTION
AS 
MEDICAL ASSISTANCE.—Section 1905(a) of the Social Se-
curity Act (42 U.S.C. 1396d(a)) is amended— 
(1) in paragraph (31), by striking ‘‘and’’ at the 
end; 
(2) by redesignating paragraph (32) as para-
graph (33); and 
(3) by inserting after paragraph (31) the fol-
lowing new paragraph: 
‘‘(32) breast reconstruction following a medi-
cally necessary mastectomy; and’’. 
(c) CONFORMING AMENDMENTS.— 
(1) FMAP.—Section 1905(b)(4) of the Social 
Security Act (42 U.S.C. 1396d(b)(4)) is amended by 
striking ‘‘section 1902(a)(10)(A)(ii)(XVIII)’’ and in-
serting ‘‘section 1902(a)(10)(A)(i)(X)’’. 
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(2) COST SHARING.— 
(A) IN GENERAL.—Subsections (a)(2) and 
(b)(2) of section 1916 of the Social Security 
Act (42 U.S.C. 1396o) are each amended— 
(i) in subparagraph (I), by striking 
‘‘or’’ at the end; 
(ii) in subparagraph (J), by striking 
‘‘; and’’ at the end and inserting ‘‘, or’’; 
and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(K) items and services furnished to individuals 
described in section 1902(aa); and’’. 
(B) ALTERNATIVE
COST
SHARING.—Sec-
tion 1916A(b)(3) of the Social Security Act (42 
U.S.C. 1396o–1(b)(3)) is amended— 
(i) in subparagraph (A)(v), by striking 
‘‘1902(a)(10)(A)(ii)(XVIII)’’ and inserting 
‘‘1902(a)(10)(A)(i)(X)’’; and 
(ii) in subparagraph (B)(viii), by 
striking ‘‘1902(a)(10)(A)(ii)(XVIII)’’ and 
inserting ‘‘1902(a)(10)(A)(i)(X)’’. 
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(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply beginning 1 year after the date 
of the enactment of this Act. 
Æ 
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