Real bill currently in Congress  c/o  HR/119/10100

Screen to Save Act

Policy area: Health ▲ 11 days since action Sponsor: Joe Neguse, CO-02, D → Congress.gov

Latest action (2026-08-13): 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.

The Framers

“Founders’ Verdict”

CONSTITUTIONAL

Confidence 0.75

Synthesis

The bill is constitutional because Congress has the power to regulate interstate commerce and provide for the general welfare under Article I, Section 8, and the necessary and proper clause, as well as the spending power, to mandate no-cost screening mammography through federal health programs and insurance regulation.

Hamilton YES

The Congress possesses the power to regulate commerce among the several states, and to provide for the general welfare, as enumerated in Article I, Section 8, Clause 1 and Clause 3. The provision of no-cost coverage for annual screening mammography beginning at age 30, through amendments to the Social Security Act and the Public Health Service Act, falls within the scope of these powers, as it addresses a matter of interstate commerce and public health. The Federalist No. 23 affirms the necessity of granting the federal government powers commensurate with the objects of its charge, and here th…

Article I, Section 8, Clause 1 Article I, Section 8, Clause 3 Federalist No. 23
Jefferson NO

This bill exceeds the powers delegated to the federal government. Nowhere in the Constitution is the Congress empowered to prescribe the terms of private health contracts or mandate the coverage of specific medical procedures for the general citizenry. The enumerated powers of Article I, Section 8 are few and defined; the power to regulate commerce among the several states does not extend to the internal police of health, which remains reserved to the states and the people. The General Welfare Clause is not a separate grant of authority, but a limitation upon the spending power, confined to th…

Amendment X Article I, Section 8
Madison YES

Congress possesses authority to enact this legislation under its enumerated power to lay and collect taxes to provide for the general welfare, as articulated in Article I, Section 8, Clause 1. The bill operates as a condition on federal healthcare expenditures and insurance standards, fitting within the spending power's legitimate scope. While I caution against expanding federal authority beyond its enumerated limits, this measure directly addresses a national concern for preventive health and attaches to existing federal programs (Medicare, Medicaid, and federally regulated insurance markets)…

Article I, Section 8, Clause 1 Federalist No. 41
Marshall YES

This bill, directing the provision of no-cost screening mammography through federal health programs and insurance regulation, is a legitimate exercise of Congress's power to tax and spend for the general welfare and to regulate interstate commerce. The Social Security Act and the Public Health Service Act operate within the sphere of federal authority to provide for the public welfare and to regulate commercial activities that affect the national economy. The coverage mandates and financial incentives attached to federal health programs are appropriate means to achieve the legitimate end of pu…

Article I, Section 8, Clause 1 Article I, Section 8, Clause 18 Gibbons v. Ogden (1824) McCulloch v. Maryland (1819)

What should pass

“AI Consensus Solution”

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Early Breast Cancer Detection Act of 2025

To require that health insurance plans cover annual screening mammography for women beginning at age 30 without cost-sharing, thereby increasing early detection of breast cancer and reducing mortality disparities.

Bipartisan rationale: Honors Democratic priorities: expands preventive care access for women, reduces racial and income disparities in breast cancer detection, builds on the ACA preventive services framework, and includes a federal matching incentive for Medicaid. Honors Republican priorities: contains a 5-year sunset for fiscal discipline, includes a small business waiver to reduce regulatory burden, funds the expansion through user fees (high-income premium surcharge and insurance fee) rather than broad tax increases, and preserves state flexibility through a structured compliance mechanism rather than a blanket mandate.

Funding: 0.5% surcharge on Medicare Part B premiums Estimated cost: $2.5 billion p Sunset 5y Oversight: Department of Health and Human Enforcement: Civil monetary penalties up to $10,0

Vote-count path: ~260 House votes: 170 Democrats (progressive and moderate) + 90 Republicans (fiscal hawks who support the sunset and small business waiver, and some from the women's health caucus); ~58 Senate votes: 48 Democrats (including all but a few left-leaning no-votes due to the high-income surcharge) + 10 Republicans (from the health committee and oversight-focused members).

→ Article I, Section 8, Clause 1 (Congress's power to lay and collect taxes and spend for the general welfare, supporting Medicare and Medicaid expansions and the insurance fee) → Article I, Section 8, Clause 3 (Congress's power to regulate interstate commerce, supporting the private insurance mandate) → Amendment X (powers not delegated to the United States are reserved to the states; the Act respects this by offering states an enhanced match and graduated penalties rather than commandeering state legislatures)

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