Ovarian Cancer IMPACT Act
- Sponsor
- Sen. Slotkin, Elissa [D-MI]
- Committees
- Health, Education, Labor, and Pensions Committee (primary)
- Last action
- Sep 24, 2026
Bottom line
The Ovarian Cancer IMPACT Act aims to improve ovarian cancer outcomes by increasing awareness, expanding access to genetic services and specialized care, and mandating insurance coverage for these critical services.
What it actually does
This bill reauthorizes and expands 'Johanna's Law' to enhance ovarian cancer awareness, particularly for high-risk and underserved populations, and establishes demonstration projects for outreach strategies. It mandates that group health plans and health insurance issuers, including grandfathered plans, cover genetic counseling, multi-gene panel testing, and risk-reducing interventions for individuals at elevated hereditary risk of ovarian cancer. Additionally, it integrates ovarian cancer services into existing rural health care grant programs and the 'Expanding Capacity for Health Outcomes' (ECHO) program.
Proponents argue
Supporters argue that the bill is crucial for saving lives by promoting early recognition of symptoms, leveraging advances in genetic science for prevention and personalized treatment, and addressing significant disparities in access to specialized care, especially in rural and medically underserved communities. They contend that increased awareness and mandated coverage for genetic testing and risk-reducing interventions will lead to earlier diagnoses, more effective treatments, and ultimately, reduced mortality rates.
Opponents contend
Critics might raise concerns about the potential for increased healthcare costs due to new federal mandates on private health insurance plans, which could lead to higher premiums for consumers and employers. Some may also question the administrative burden on insurers and healthcare providers to implement the new coverage requirements and expand services, particularly in areas with existing workforce shortages.
The bill is relatively short and clearly structured, making it accessible for an informed reader to understand its provisions and implications within a reasonable timeframe.
Section 3(1)
Enhanced Ovarian Cancer Awareness and Education Campaign
This provision expands the national ovarian cancer awareness campaign under Johanna's Law. It requires developing and disseminating culturally and linguistically appropriate materials, conducting targeted outreach to high-risk populations (based on race, ethnicity, genetic predisposition, or family history), promoting awareness of hereditary cancer syndromes (like BRCA1/2 and Lynch syndrome), and providing information on insurance coverage for genetic services and evidence-based risk-reduction strategies, including opportunistic salpingectomy.
Supporters argue
Supporters argue that this enhanced campaign is vital for improving public health outcomes by ensuring critical, up-to-date information reaches those most at risk and those who care for them, directly addressing current knowledge gaps and disparities.
Critics contend
No specific opposition is typically raised against public health awareness campaigns, though some might raise concerns about the efficiency of resource allocation or the scope of federal involvement in public education.
Tradeoffs
The provision balances the need for broad public awareness with the necessity of targeted outreach to specific, often vulnerable, populations, requiring careful resource allocation to maximize impact.
Section 3(2)
Ovarian Cancer Demonstration Projects
This section authorizes the Secretary of HHS to award grants for demonstration projects. These projects will test and evaluate innovative outreach strategies related to ovarian cancer awareness, hereditary cancer risk assessment, genetic counseling, genetic testing, and access to specialty care. Preference will be given to applicants experienced in serving rural, medically underserved, or high-risk populations. Grantees include public health departments, community health centers, rural hospitals, academic medical centers, and nonprofit organizations.
Section 3(3)
Reauthorization of Appropriations for Johanna's Law
This provision reauthorizes appropriations for carrying out Johanna's Law, as amended by this Act. It authorizes $20,000,000 to be appropriated for each of fiscal years 2027 through 2031, totaling $100,000,000 over five years, to fund the expanded awareness campaigns, demonstration projects, and other related activities.
Section 4(a)
Inclusion of Ovarian Cancer Services in Rural Health Care Outreach Grants
This provision amends the Public Health Service Act to explicitly include ovarian cancer prevention, diagnosis, treatment, survivorship services, hereditary cancer risk assessment, genetic counseling, and care coordination as eligible activities for Rural Health Care Services Outreach Grants. It also expands the eligibility for these grants to specifically include Tribal communities.
Section 4(b)
Inclusion of Ovarian Cancer in Expanding Capacity for Health Outcomes Program
This provision amends the Public Health Service Act to add ovarian cancer to the list of conditions for which the 'Expanding Capacity for Health Outcomes' (ECHO) program can provide training and support. The ECHO model uses teleconferencing to connect specialist teams with primary care providers in rural and underserved areas, enabling them to manage complex conditions locally.
Section 5(a), new Section 2729A(a)
Mandated Coverage for Genetic and Genomic Testing for Ovarian Cancer Risk
This provision requires group health plans and health insurance issuers to provide coverage for genetic counseling by a certified provider, multi-gene panel testing for germline mutations, single-gene testing, and tumor genomic profiling for somatic mutations. This coverage is mandated for individuals with a personal history of ovarian or endometrial cancer, or a family history indicative of hereditary ovarian cancer, Lynch syndrome, or other associated hereditary cancer syndromes. The scope of testing includes specific genes (BRCA1/2, BRIP1, RAD51C, RAD51D) and biomarkers (mismatch repair deficiency, microsatellite instability) as recommended by evidence-based clinical guidelines.
Section 5(a), new Section 2729A(b)
Mandated Coverage for Early Detection and Risk-Reducing Interventions
This provision requires group health plans and health insurance issuers to provide coverage for evidence-based early detection, hereditary cancer risk management, risk-reducing surgeries (such as opportunistic salpingectomy), and other interventions. This coverage is for individuals identified as being at elevated hereditary risk of ovarian cancer, where indicated under nationally recognized oncology professional organization guidelines, and applies regardless of whether the enrollee has a personal history of ovarian or endometrial cancer.
Section 5(b)
Application to Grandfathered Health Plans
This provision amends the Patient Protection and Affordable Care Act to ensure that the new standards for ovarian cancer genetic and genomic testing and risk-reducing interventions apply to 'grandfathered' health plans. These plans are typically exempt from certain requirements of the Affordable Care Act, but this amendment brings them under the purview of the new mandates.
This clause specifies that if there are conflicting evidence-based clinical practice guidelines developed by more than one nationally recognized oncology professional organization regarding genetic testing, the least restrictive of such guidelines shall apply for coverage purposes.
Section 5(a), new Section 2729A(a)(3)
Why it matters:This is standard legislative practice to address potential ambiguities or conflicts in medical guidelines, but its impact on the breadth of insurance coverage is significant, as it defaults to the most inclusive standard.
Case for: Proponents argue this ensures patients receive the broadest possible coverage for necessary genetic testing, preventing insurers from denying coverage based on the most restrictive interpretation of clinical guidelines, thereby maximizing access to potentially life-saving information.
Case against: Insurers might argue that defaulting to the 'least restrictive' guideline could lead to unnecessary testing and increased costs if less restrictive guidelines are adopted without robust, universally accepted evidence, potentially driving up premiums.
Estimated impact: This provision has the potential to broaden access to genetic testing for a larger pool of individuals by ensuring that coverage is not limited by conflicting or overly conservative guidelines.
This 'Rule of Construction' clarifies that nothing in the section shall be construed to require an enrollee to receive testing, early detection, or risk-reducing interventions described in this section.
Section 5(a), new Section 2729A(c)
Why it matters:This is standard legislative practice to protect patient autonomy and ensure that mandated insurance coverage does not inadvertently lead to mandatory medical procedures, but it is a crucial safeguard for individual rights.
Case for: Proponents argue this clause is essential for protecting individual choice and ensuring that while the bill expands access to critical services, it explicitly respects a patient's right to refuse any medical intervention, upholding ethical principles of informed consent.
Case against: There is no direct case against this provision, as it upholds fundamental patient rights and autonomy in healthcare decisions.
Estimated impact: This provision ensures that the bill's coverage mandates do not infringe upon patient autonomy, allowing individuals to make personal health decisions without coercion.