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Cardiovascular Disease Early Detection and Prevention Act of 2026
To amend title XXVII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to require coverage of certain cardiovascular tests without cost sharing under group health plans, group and individual health insurance coverage, and the Medicare and Medicaid programs.
Summary
This bill would require private health insurance plans, Medicare, and Medicaid to cover testing for lipoprotein(a) and apolipoprotein B levels without cost sharing (copayments, coinsurance, or deductibles) for individuals at risk for cardiovascular disease. The bill covers individuals with a family history of premature cardiovascular disease, a personal history of heart attack or stroke, elevated LDL cholesterol, diabetes mellitus, obesity, or other recognized cardiovascular risk factors. The coverage requirements apply to group health plans, individual and group insurance coverage, Medicare, and Medicaid, and would become effective 180 days after enactment. The bill is based on congressional findings that cardiovascular disease is the leading cause of death in the United States and that testing for these lipid levels better predicts cardiovascular risk than standard cholesterol testing alone.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
Actions (2)
- Apr 14, 2026 Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. · house
- Apr 14, 2026 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Full text
IN THE HOUSE OF REPRESENTATIVES
April 14, 2026
Mrs. Cherfilus-McCormick introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
A BILL
To amend title XXVII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to require coverage of certain cardiovascular tests without cost sharing under group health plans, group and individual health insurance coverage, and the Medicare and Medicaid programs.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Cardiovascular Disease Early Detection and Prevention Act of 2026”.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Cardiovascular disease is the leading cause of death in the United States.
(2) Routine cholesterol panels often fail to detect elevated Lipoprotein(a) (Lp(a)) and Apolipoprotein B (ApoB) levels.
(3) Approximately 1 in 5 Americans have elevated Lp(a) levels.
(4) Elevated ApoB levels predict cardiovascular risk better than LDL cholesterol alone.
(5) Nearly 50 percent of heart attack survivors die within five years without effective risk management.
SEC. 3. REQUIRING COVERAGE OF CERTAIN CARDIOVASCULAR TESTS WITHOUT COST SHARING UNDER GROUP HEALTH PLANS, GROUP AND INDIVIDUAL HEALTH INSURANCE COVERAGE, AND THE MEDICARE AND MEDICAID PROGRAMS.
(a) Public Health Service Act.—Section 2713(a) of the Public Health Service Act (42 U.S.C. 300gg-13(a)) is amended—
(1) in paragraph (2), by striking “and” at the end;
(2) in paragraph (3), by striking the period and inserting a semicolon;
(3) by redesignating paragraphs (4) and (5) as paragraphs
(5) and (6), respectively; and
(4) by inserting after paragraph (3) the following new paragraph:
“(4) with respect to individuals with a family history of premature cardiovascular disease, a personal history of myocardial infarction, stroke, or elevated LDL cholesterol, a diagnosis of diabetes mellitus or obesity, or other recognized cardiovascular risk factors, testing for lipoprotein(a) and apolipoprotein B levels; and”.
(b) Medicare.—
(1) In general.—Section 1861(xx)(1) of the Social Security Act (42 U.S.C. 1395x(xx)(1)) is amended—
(A) by redesignating subparagraph (B) as subparagraph (C);
(B) by inserting after subparagraph (A) the following new subparagraph:
“(B) In the case of an individual with a family history of premature cardiovascular disease, a personal history of myocardial infarction, stroke, or elevated LDL cholesterol, a diagnosis of diabetes mellitus or obesity, or other recognized cardiovascular risk factors, lipoprotein(a) and apolipoprotein B levels.”; and
(C) in the flush matter at the end, by striking “subparagraph (B)” and inserting “subparagraph
(C)”.
(2) No application of cost sharing.—Section 1833 of the Social Security Act (42 U.S.C. 1395l) is amended—
(A) in subsection (a)(1)(Y), by inserting “(other than tests for levels described in section 1861(ww)(1)(B) furnished to an individual described in such section)” after “described in subparagraph
(A)”; and
(B) in subsection (b)(1), by striking “for the individual.” inserting “for the individual or that are tests for levels described in section 1861(ww)(1)(B) furnished to an individual described in such section”.
(c) Medicaid.—
(1) In general.—Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended—
(A) in paragraph (31), by striking “and” at the end;
(B) by redesignating paragraph (32) as paragraph
(33); and
(C) by inserting after paragraph (31) the following new paragraph:
“(32) testing for lipoprotein(a) and apolipoprotein B levels furnished to an individual with a family history of premature cardiovascular disease, a personal history of myocardial infarction, stroke, or elevated LDL cholesterol, a diagnosis of diabetes mellitus or obesity, or other recognized cardiovascular risk factors; and”.
(2) No 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” and inserting “, or”; and
(iii) by adding at the end the following new subparagraph:
“(K) testing for lipoprotein(a) and apolipoprotein B levels furnished to an individual described in section 1905(a)(32); and”.
(B) Application to alternative cost sharing.— Section 1916A(b)(3)(B) of the Social Security Act (42 U.S.C. 1396o-1(b)(3)(B)) is amended by adding at the end the following new clause:
“(xv) Testing for lipoprotein(a) and apolipoprotein B levels furnished to an individual described in section 1905(a)(32).”.
(3) Mandatory coverage.—Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended by striking “and (30)” and inserting “(30), and (32)”.
(4) Benchmark coverage and benchmark-equivalent coverage.— Section 1937(b) of the Social Security Act (42 U.S.C. 1396u- 7(b)) is amended by adding at the end the following new paragraph:
“(9) Coverage of certain lipid level testing.— Notwithstanding the previous provisions of this section, a State may not provide for medical assistance through enrollment of an individual with benchmark coverage or benchmark- equivalent coverage under this section unless such coverage provides, with respect to an individual described in section 1905(a)(32), testing for lipoprotein(a) and apolipoprotein B levels.”.
(d) Effective Date.—The amendments made by—
(1) subsection (a) shall apply with respect to plan years beginning on or after the date that is 180 days after the date of the enactment of this Act; and
(2) subsections (b) and (c) shall apply with respect to items and services and medical assistance, respectively, furnished on or after such date. <all>
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