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Read. Follow. Verify.Alabama HB 453 Requires Health Plans and Medicaid to Cover Breast Reconstruction Surgery
Last action · February 12, 2026: Pending Committee Action in House of OriginSponsor: Jennifer Fidler
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What This Bill Would Do
Starting January 1, 2027, health insurance plans in Alabama—including private plans, public employee plans, and Medicaid—must cover breast reconstruction and related services. Enrollees are permitted to choose their preferred surgical technique and can see out-of-network providers at in-network rates. Insurers failing to comply face civil liability, potential treble damages, and enforcement by the Department of Insurance and the Attorney General.
Patients undergoing mastectomy or lumpectomy gain guaranteed insurance coverage for comprehensive reconstruction and symmetry procedures without mandatory network restrictions or financial penalties for out-of-network care.
- State legislatures frequently introduce health insurance mandate bills to ensure coverage for specialized post-surgical care such as reconstructive procedures following cancer treatments. context
Who It Would Affect
Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.
Health Insurers
Insurers must update health benefit plans to cover breast reconstruction, adhere to a three-day prior authorization response window, and comply with out-of-network reimbursement rules.
Enrollees
Patients gain guaranteed health plan coverage for all forms of breast reconstruction, the right to use out-of-network providers at in-network cost-sharing rates, and the ability to file civil actions for non-compliance.
Health Care Professionals
Surgeons and physicians gain single-case agreement negotiation timelines and protections when rendering breast reconstruction services to covered patients.
Alabama Medicaid Agency
The agency is required to incorporate breast reconstruction coverage into its existing medical service delivery programs starting January 1, 2027.
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
When does the mandatory breast reconstruction coverage take effect?
Can I choose an out-of-network surgeon for my reconstruction?
What happens if my insurer denies prior authorization?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Currently in committee. The next step in the legislative lifecycle is Floor Vote.
Procedural history
2 actions- Feb 12, 2026HouseCommitteePending Committee Action in House of Origin
- Feb 12, 2026HouseIntroducedRead for the first time and referred to the House Committee on Insurance
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Expansion of Public Plan Mandates
The bill integrates private insurance rules directly into public sector programs including Medicaid, the State Employees' Health Insurance Plan, and the Public Education Employees' Health Insurance Plan.
Connected Entities
Sources
alison.legislature.state.al.us
Analysis Score
0–100- Significance85How much this matters to a regular citizen
- Controversy40Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz45Current news / social attention level
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