Colorectal Cancer Payment Fairness Act
- Sponsor
- Sen. Booker, Cory A. [D-NJ]
- Committees
- Environment and Public Works Committee (primary)
- Last action
- Sep 30, 2025
Bottom line
The bill makes colorectal cancer screenings entirely free for Medicare beneficiaries starting in 2026, removing financial barriers to this preventative care.
What it actually does
This bill amends the Social Security Act to eliminate the coinsurance requirement for certain colorectal cancer screening tests furnished under the Medicare program. It removes the existing sunset clause for this coinsurance phase-out and accelerates the full elimination of beneficiary cost-sharing to 100 percent coverage by Medicare for 2026 and each subsequent year, rather than the previously scheduled 2030.
Proponents argue
Supporters argue that eliminating coinsurance for colorectal cancer screenings removes a significant financial barrier that can deter Medicare beneficiaries from undergoing these crucial preventative tests. They contend that earlier detection through increased screening rates leads to better health outcomes, reduces the need for more expensive treatments for advanced cancers, and ultimately saves lives.
Opponents contend
While direct opposition to cancer screening coverage is uncommon, potential critics might raise concerns about the increased financial burden on the Medicare trust fund. They could argue that accelerating the phase-out by four years without a clear offset adds to federal spending, especially given existing fiscal pressures on the program.
The bill is exceptionally short and clear, making it very easy for any reader to understand its provisions and implications quickly.
Section 2
Eliminating Coinsurance for Colorectal Cancer Screening Tests
This provision modifies Section 1833(dd) of the Social Security Act. It strikes the current limitation that phases out coinsurance only until January 1, 2030. Furthermore, it explicitly sets the Medicare payment percentage for these screenings at 100 percent for 2026 and all subsequent years, meaning beneficiaries will pay no coinsurance from that point forward, accelerating the full elimination of cost-sharing by four years.
Supporters argue
Proponents argue that removing the coinsurance completely will significantly boost screening rates among Medicare beneficiaries, leading to earlier detection of colorectal cancer. This early detection is critical for successful treatment and improved survival rates, aligning with public health goals to reduce cancer mortality.
Critics contend
Critics, while generally supportive of preventative care, might argue that accelerating the coinsurance elimination by four years places an additional, unbudgeted burden on the Medicare system. They may question the immediate necessity of this acceleration versus the fiscal implications, especially when a phase-out was already in progress.
Tradeoffs
The provision balances the public health benefit of increased access to preventative cancer screenings against the fiscal impact of shifting the full cost of these services onto the Medicare program, potentially increasing federal expenditures.