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SB1165 • 2026

insurance; cost sharing; breast exams

SB1165 - insurance; cost sharing; breast exams

Healthcare Labor
Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Hildy Angius, Frank Carroll, Eva Diaz, Catherine Miranda, Carine Werner
Last action
2026-03-31
Official status
House committee of the whole
Effective date
Not listed

Plain English Breakdown

The candidate explanation included details about HDHPs that were not directly relevant or specified in the bill's summary.

Insurance Rules for Breast Cancer Screenings

This bill stops health insurance companies from requiring people to pay extra costs for breast cancer screening tests and follow-up exams needed to complete the screening process starting January 1, 2027.

What This Bill Does

  • Health insurers cannot charge extra fees (like deductibles or copayments) for preventative breast cancer screenings starting January 1, 2027.
  • If a health plan has a high deductible, people still don't have to pay extra costs for preventive care after the deductible is met.
  • The bill defines what types of exams are covered under 'preventative screening services' and 'additional screening services'.

Who It Names or Affects

  • People with health insurance in Arizona.
  • Health insurers who provide coverage in Arizona.

Terms To Know

Cost Sharing
This includes deductibles, coinsurance, copayments or any other out-of-pocket expenses that a person has to pay for healthcare services.
High Deductible Health Plan (HDHP)
A type of health insurance plan with higher deductibles and lower premiums. It allows people to contribute to a Health Savings Account (HSA).

Limits and Unknowns

  • The bill does not specify what happens if the changes affect employer contributions for state employee health plans.
  • It is unclear how this will impact insurance costs or coverage beyond January 1, 2027.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Plain English: Fifty-seventh Legislature Finance Second Regular Session S.B.

  • Fifty-seventh Legislature Finance Second Regular Session S.B.
  • 1165 COMMITTEE ON FINANCE SENATE AMENDMENTS TO S.B.
  • 1165 (Reference to printed bill) The bill as proposed to be amended is reprinted as follows: 1 Section 1.
  • Title 20, chapter 4, article 3, Arizona Revised 2 Statutes, is amended by adding section 20-841.14, to read: 3 20-841.14.
  • This amendment summary is using official source text because generated interpretation was skipped for this run.

Plain English: Fifty-seventh Legislature Finance Second Regular Session S.B.

  • Fifty-seventh Legislature Finance Second Regular Session S.B.
  • 1165 PROPOSED SENATE AMENDMENTS TO S.B.
  • 1165 (Reference to printed bill) The bill as proposed to be amended is reprinted as follows: 1 Section 1.
  • Title 20, chapter 4, article 3, Arizona Revised 2 Statutes, is amended by adding section 20-841.14, to read: 3 20-841.14.
  • This amendment summary is using official source text because generated interpretation was skipped for this run.

Bill History

  1. 2026-03-31 House

    House committee of the whole

  2. 2026-03-24 House

    House minority caucus

  3. 2026-03-24 House

    House majority caucus

  4. 2026-03-23 House

    House consent calendar

  5. 2026-03-09 House

    House second read

  6. 2026-03-05 House

    House Rules: C&P

  7. 2026-03-05 House

    House Health & Human Services: DP

  8. 2026-03-05 House

    House first read

  9. 2026-03-02 House

    Transmitted to House

  10. 2026-03-02 Senate

    Senate third read passed

  11. 2026-03-02 Senate

    Senate committee of the whole

  12. 2026-02-25 Senate

    Senate minority caucus

  13. 2026-02-23 Senate

    Senate majority caucus

  14. 2026-01-21 Senate

    Senate second read

  15. 2026-01-20 Senate

    Senate Rules: PFC

  16. 2026-01-20 Senate

    Senate Finance: DPA

  17. 2026-01-20 Senate

    Senate first read

Official Summary Text

SB1165 - 572R - Senate Fact Sheet

Assigned to
FIN������������������������������������������������������������������������������������������������� AS
PASSED BY COMMITTEE

ARIZONA STATE SENATE

Fifty-Seventh
Legislature, Second Regular Session

AMENDED

FACT SHEET FOR
S.B. 1165

insurance; cost
sharing; breast exams

Purpose

Prohibits, for
contracts, evidences of coverage and policies issued on or after January 1,
2027, a hospital or medical service corporation, health care services
organization, disability insurer and group or blanket disability insurer
(health insurer) from imposing cost sharing requirements
for
preventative screening services for breast cancer or for additional screening
services required to complete the screening continuum.

Background

The Department of Insurance and Financial Institutions regulates
policies, certificates, evidences of coverage and contracts of insurance (insurance
policies) that are issued or delivered by health care insurers.
Health care
insurers
include disability insurers, group disability insurers, blanket
disability insurers, health care services organizations, hospital service
corporations and medical service corporations (
A.R.S.
� 20-1379
).

Statute requires that health insurance contracts providing coverage for
mastectomy surgical services also provide coverage for preventive mammography
screening and diagnostic imaging performed on dedicated equipment for
diagnostic purposes on referral by a patient's physician subject to the terms
and conditions of the policy, including deductibles and coinsurance (A.R.S. ��
20-826
;

20-1057
;

20-1342
;
and
20-1402
).

Federal law defines
high deductible health plan
(HDHP) as a health
plan that has an annual deductible which is not less than a specified amount
and for which the sum of the annual deductible and the other annual
out-of-pocket expenses required to be paid under the plan for covered benefits
does not exceed a separate specified limit (
26
U.S.C. � 223
).

Federal law allows an HDHP to provide coverage for preventive care
without a deductible while maintaining the plan's legal status for health
savings account (HSA) eligibility. In 2024, the Internal Revenue Service
expanded the list of preventive care benefits to be provided by an HDHP without
a deductible, or with a deductible below the applicable minimum deductible for
the HDHP, to include all types of breast cancer screening for individuals who
have not been diagnosed with breast cancer (
IRS Notice 2024-75
).

If prohibiting health insurers from imposing cost-sharing requirements
for preventative screening services for breast cancer or for additional
screening services required to complete the screening continuum results in a
change to employer contributions for the state employee health plan, there may
be a fiscal impact to the state General Fund.

Provisions

1.

Prohibits a health insurer that issues, amends, delivers or renews an insurance
policy on or after January 1, 2027, from imposing cost sharing requirements for
preventative screening services for breast cancer or for additional screening
services required to complete the screening continuum, including a diagnostic
breast examination and a supplemental breast examination.

2.

Applies, if an insurance policy includes an HDHP, the cost sharing prohibition
after the deductible is met, except that if the items or services are
preventive, the prohibition applies regardless of whether the minimum
deductible has been met.

3.

Defines
cost sharing
as a deductible, coinsurance, copayment or
maximum limitation on the application of the deductible, coinsurance, copayment
or similar out-of-pocket expense.

4.

Defines
additional screening services
to include a diagnostic
breast examination and a supplemental breast examination.

5.

Defines

diagnostic breast examination
as a medically necessary and appropriate
examination of the breast in accordance with the National Comprehensive Cancer Network
guidelines and includes a breast examination using contrast enhanced
mammography, diagnostic mammography, breast magnetic resonance imaging or
breast ultrasound or molecular breast imaging that is used to either:

a)

evaluate an abnormality that is seen or suspected from a screening
examination for breast cancer; or

b)

evaluate
an abnormality that is detected by another means of examination.

6.

Defines
preventative screening services for breast cancer
as a
screening mammography, which means x-ray imaging of the breast of asymptomatic
persons and includes digital breast tomosynthesis.

7.

Defines

supplemental breast examination
as a medically necessary and appropriate
examination of the breast in accordance with the National Comprehensive Cancer Network
guidelines and includes a breast examination using contrast enhanced
mammography, breast magnetic resonance imaging or breast ultrasound or
molecular breast imaging that is both:

a)

used to screen for breast cancer when there is no abnormality seen or
suspected; and

b)

based
on a personal or family medical history or additional factors that increase an
individual's risk of breast cancer, including heterogenous or extremely dense
breasts.

8.

Becomes effective on the general effective date.

Amendments Adopted by
Committee

1.

Modifies the prohibition on a health insurer by prohibiting cost sharing
for preventative screening services for breast cancer and for additional
screening services required to complete the screening continuum, rather than
only prohibiting cost sharing for diagnostic and supplemental breast
examinations.

2.

Defines
additional screening
and
preventative screening
service for breast cancer.

3.

Makes conforming changes.

Senate Action

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Prepared by Senate Research

February 18, 2026

MG/SJ/hk

Current Bill Text

Read the full stored bill text
SB1165 - 572R - S Ver

Senate Engrossed

insurance; cost
sharing; breast exams

State of Arizona

Senate

Fifty-seventh Legislature

Second Regular Session

2026

SENATE BILL 1165

AN
ACT

amending title 20, chapter 4, article 3,
Arizona Revised Statutes, by adding section 20-841.14; amending title 20,
chapter 4, article 9, Arizona Revised Statutes, by adding section 20-1057.21;
amending title 20, chapter 6, article 4, Arizona Revised Statutes, by adding
section 20-1376.11; amending title 20, chapter 6, article 5, Arizona
Revised Statutes, by adding section 20-1406.11; relating to health
insurance.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it
enacted by the Legislature of the State of Arizona:

Section 1. Title 20, chapter 4, article 3,
Arizona Revised Statutes, is amended by adding section 20-841.14, to read:

START_STATUTE
20-841.14.

Breast examinations; cost sharing; exception; definitions

A. a hospital service corporation or
medical service corporation that issues, amends, delivers or renews a
subscription contract On or after January 1, 2027 may not impose cost sharing
requirements for
PREVENTATIVE SCREENING SERVICES FOR
BREAST CANCER OR FOR ADDITIONAL SCREENING SERVICES REQUIRED TO COMPLETE THE
SCREENING CONTINUUM.�

b. If a subscription contract
includes a high deductible health plan as defined in 26 United States Code
section 223(
c
)(2)(a), subsection A of this section
applies after the deductible is met, except that if the items or services are
preventive as prescribed in 26 United States Code section 223(
c
)(2)(C), subsection A of this section applies regardless of whether
the minimum deductible under 26 United States Code section 223 has been met.

C. For the purposes of this section:

1. "aDDITIONAL SCREENING
SERVICES" INCLUDES A DIAGNOSTIC BREAST EXAMINATION AND A SUPPLEMENTAL
BREAST EXAMINATION.

2. "Cost sharing" means a
deductible, coinsurance, copayment or maximum limitation on the application of
the deductible, coinsurance, copayment or similar out-of-pocket
expense.

3. "Diagnostic Breast
Examination":

(
a
) Means a
medically necessary and appropriate examination of the breast in accordance
with the National Comprehensive Cancer Network Guidelines.

(
b
) Includes an
examination of the breast using contrast enhanced mammography, diagnostic
mammography, breast magnetic resonance imaging or breast ultrasound or
molecular breast imaging that is used to either:

(
i
) Evaluate an
abnormality that is seen or suspected from a screening examination for breast
cancer.

(
ii
) Evaluate
an abnormality that is detected by another means of examination.

4. "pREVENTATIVE SCREENING
SERVICE FOR BREAST CANCER" MEANS SCREENING MAMMOGRAPHY AS DEFINED IN
SECTION 30-651.

5. "Supplemental breast
examination":

(
a
) means a
medically necessary and appropriate examination of the breast in accordance
with the National Comprehensive Cancer Network guidelines.

(
b
) Includes an
examination of the breast using contrast enhanced mammography, breast magnetic
resonance imaging or breast ultrasound or molecular breast imaging that is
both:

(
i
) Used to
screen for breast cancer when there is no abnormality seen or suspected.

(
ii
) Based on a
personal or family medical history or additional factors that increase an
individual's risk of breast cancer, including heterogenous or extremely dense
breasts.
END_STATUTE

Sec. 2. Title
20, chapter 4, article 9, Arizona Revised Statutes, is amended by adding
section 20-1057.21, to read:

START_STATUTE
20-1057.21.

Breast examinations; cost sharing; exception; definitions

A. a health care services
organization that issues, amends, delivers or renews an evidence of coverage On
or after January 1, 2027 may not impose cost sharing requirements for
PREVENTATIVE SCREENING SERVICES FOR BREAST CANCER OR FOR ADDITIONAL
SCREENING SERVICES REQUIRED TO COMPLETE THE SCREENING CONTINUUM.

B. If an evidence of coverage
includes a high deductible health plan as defined in 26 United States Code
section 223(
c
)(2)(a), subsection A of this section
applies after the deductible is met, except that if the items or services are
preventive as prescribed in 26 United States Code section 223(
c
)(2)(C), subsection A of this section applies regardless of whether
the minimum deductible under 26 United States Code section 223 has been met.

c. For the purposes of this section:

1. "additional screening
services" includes a diagnostic breast examination and a supplemental
breast examination.

2. "Cost sharing" means a
deductible, coinsurance, copayment or maximum limitation on the application of
the deductible, coinsurance, copayment or similar out-of-pocket
expense.

3. "Diagnostic Breast
Examination":

(
a
) Means a
medically necessary and appropriate examination of the breast in accordance
with the National Comprehensive Cancer Network Guidelines.

(
b
) Includes an
examination of the breast using contrast enhanced mammography, diagnostic
mammography, breast magnetic resonance imaging or breast ultrasound or
molecular breast imaging that is used to either:

(
i
) Evaluate an
abnormality that is seen or suspected from a screening examination for breast
cancer.

(
ii
) Evaluate
an abnormality that is detected by another means of examination.

4. "preventative screening services for
breast cancer" means screening mammography as defined in section 30-651.

5. "Supplemental breast
examination":

(
a
) means a
medically necessary and appropriate examination of the breast in accordance
with the National Comprehensive Cancer Network guidelines.

(
b
) Includes an
examination of the breast using contrast enhanced mammography, breast magnetic
resonance imaging or breast ultrasound or molecular breast imaging that is
both:

(
i
) Used to
screen for breast cancer when there is no abnormality seen or suspected.

(
ii
) Based on a
personal or family medical history or additional factors that increase an
individual's risk of breast cancer, including heterogenous or extremely dense
breasts.
END_STATUTE

Sec. 3. Title
20, chapter 6, article 4, Arizona Revised Statutes, is amended by adding
section 20-1376.11, to read:

START_STATUTE
20-1376.11.

Breast examinations; cost sharing; exception; definitions

A. a disability insurer that issues,
amends, delivers or renews a policy On or after January 1, 2027 may not impose
cost sharing requirements for
preventative screening
services for breast cancer or for additional screening services required to
complete the screening continuum.

b. If a policy includes a high
deductible health plan as defined in 26 United States Code section 223(
c
)(2)(a), subsection A of this section applies after the deductible is
met, except that if the items or services are preventive as prescribed in 26
United States Code section 223(
c
)(2)(C), subsection A of
this section applies regardless of whether the minimum deductible under 26
United States Code section 223 has been met.

c. For
the purposes of this section:

1. "additional
screening services" includes a diagnostic breast examination and a
supplemental breast examination.

2. "Cost
sharing" means a deductible, coinsurance, copayment or maximum limitation
on the application of the deductible, coinsurance, copayment or similar out-of-pocket
expense.

3. "Diagnostic Breast
Examination":

(
a
) Means a
medically necessary and appropriate examination of the breast in accordance
with the National Comprehensive Cancer Network Guidelines.

(
b
) Includes an
examination of the breast using contrast enhanced mammography, diagnostic
mammography, breast magnetic resonance imaging or breast ultrasound or
molecular breast imaging that is used to either:

(
i
) Evaluate an
abnormality that is seen or suspected from a screening examination for breast
cancer.

(
ii
) Evaluate
an abnormality that is detected by another means of examination.

4. "preventative screening
services for breast cancer" means screening mammography as defined in
section 30-651.

5. "Supplemental breast
examination":

(
a
) means a
medically necessary and appropriate examination of the breast in accordance
with the National Comprehensive Cancer Network guidelines.

(
b
) Includes an
examination of the breast using contrast enhanced mammography, breast magnetic
resonance imaging or breast ultrasound or molecular breast imaging that is
both:

(
i
) Used to
screen for breast cancer when there is no abnormality seen or suspected.

(
ii
) Based on a
personal or family medical history or additional factors that increase an
individual's risk of breast cancer, including heterogenous or extremely dense
breasts.
END_STATUTE

Sec. 4. Title
20, chapter 6, article 5, Arizona Revised Statutes, is amended by adding
section 20-1406.11, to read:

START_STATUTE
20-1406.11.

Breast examinations; cost sharing; exception; definitions

A. a group or blanket disability
insurer that issues, amends, delivers or renews a policy On or after January 1,
2027 may not impose cost sharing requirements for
preventative
screening services for breast cancer or for additional screening services
required to complete screening continuum.

b. If a policy includes a high
deductible health plan as defined in 26 United States Code section 223(
c
)(2)(a), subsection A of this section applies after the deductible is
met, except that if the items or services are preventive as prescribed in 26
United States Code section 223(
c
)(2)(C), subsection A of
this section applies regardless of whether the minimum deductible under 26
United States Code section 223 has been met.

c. For the purposes of this section:

1. "additional screening
services" includes a diagnostic breast examination and a supplemental
breast examination.

2. "Cost sharing" means a
deductible, coinsurance, copayment or maximum limitation on the application of
the deductible, coinsurance, copayment or similar out-of-pocket
expense.

3. "Diagnostic
Breast Examination":

(
a
) Means a medically necessary and appropriate examination
of the breast in accordance with the National Comprehensive Cancer Network
Guidelines.

(
b
) Includes an
examination of the breast using contrast enhanced mammography, diagnostic
mammography, breast magnetic resonance imaging or breast ultrasound or
molecular breast imaging that is used to either:

(
i
) Evaluate an
abnormality that is seen or suspected from a screening examination for breast
cancer.

(
ii
) Evaluate
an abnormality that is detected by another means of examination.

4. "preventative screening
services for breast cancer" means screening mammography as defined in
section 30-651.

5. "Supplemental
breast examination":

(
a
) means a medically necessary and appropriate examination
of the breast in accordance with the National Comprehensive Cancer Network
guidelines.

(
b
) Includes an
examination of the breast using contrast enhanced mammography, breast magnetic
resonance imaging or breast ultrasound or molecular breast imaging that is both
of the following:

(
i
) Used to
screen for breast cancer when there is no abnormality seen or suspected.

(
ii
) Based on a
personal or family medical history or additional factors that increase an
individual's risk of breast cancer, including heterogenous or extremely dense
breasts.
END_STATUTE