Pennsylvania insurance plans will soon have to cover colon cancer screenings at no cost starting at age 45, five years earlier than many plans previously required, under a law that grew directly out of one state lawmaker's own brush with late-stage cancer. The measure, recorded as Act No. 72 of 2026, requires state-regulated insurers and Medicaid to pay for routine colonoscopies, stool test kits and blood-based screening tests without copays or deductibles once it takes effect next month.
Pennsylvania State Representative Pat Gallagher of Philadelphia was the lead sponsor of House Bill 1123, which became Act 72 after the state Senate passed it 50-0 on Oct. 20 and the House concurred in Senate amendments 187-16 the next day, according to Pennsylvania General Assembly records. The bill amends the state's Insurance Company Law of 1921, and legislative records list its last action as Act No. 72 of 2026 on Oct. 22. A search-result snippet from the Commonwealth of Pennsylvania names HB 1123 among a batch of bills Governor Josh Shapiro signed that day, though the full official release was not available to confirm the complete context of that signing.
Gallagher knows the stakes of the law personally. As WHYY reports, he was hospitalized with serious stomach pain in early 2020 and diagnosed with late-stage colon cancer at age 45. Doctors found four tumors during surgery, and he underwent multiple operations, a temporary colostomy and chemotherapy. He has estimated that his insurance paid close to $1 million for his care, while WHYY notes that a single screening colonoscopy costs insurers an average of about $2,500.
A Push Born From Personal Experience
Gallagher says early detection is, in his words, a step toward catching a cancer that is treatable and curable when found in time, according to the same WHYY report. He has said insurance companies were reluctant to pay for preventive care costs, and that some state-regulated plans left people under 50 without no-cost screening coverage if they had no documented family history of the disease.
The gap existed even after major health bodies moved to lower the recommended screening age. The American Cancer Society updated its guidelines in 2018 to recommend starting screening at 45 instead of 50, and the U.S. Preventive Services Task Force followed in 2021, expanding its recommended range from 50-75 to 45-75, according to the U.S. Preventive Services Task Force. Federal agencies then required private health insurance plans to cover the screenings at no cost for eligible patients, per WHYY's report, but Pennsylvania's state-regulated plans had not fully caught up until now.
Coverage Expanding Through 2028
Act 72 is scheduled to take effect Dec. 21, 2026, and will require state-regulated health insurers and Medicaid to cover modern screening methods, including blood-based tests, with zero cost-sharing, according to InsuranceNewsNet. The outlet reports the mandate is expected to eliminate out-of-pocket costs for roughly 2 million screening-eligible Pennsylvania residents. WHYY reports the law will apply to most state-regulated insurance plans by 2028, and that it does not address the potential screening needs of adults younger than 45.
The urgency behind the bill is backed by national trends. Colorectal cancer incidence is climbing 3% annually among adults ages 20 to 49, compared with 0.4% annually among those 50 to 64, according to the American Cancer Society. Nearly half of new colorectal cancer cases now occur in adults under 65, up from 27% in 1995, and the organization estimated 158,850 new cases and 55,230 deaths from the disease nationwide in 2026.
Newly Eligible Patients Still Aren't Showing Up
Even with expanded eligibility, screening hasn't caught on among the youngest covered group. Only 37% of adults ages 45 to 49 get screened for colorectal cancer, and three in four colorectal cancers in adults younger than 50 are diagnosed at an advanced stage, per the American Cancer Society's research. Half of all colorectal cancer diagnoses under age 50 occur in people ages 45 to 49 — the exact group this law targets — and the society's research highlights note that screening in newly eligible adults is especially low when it comes to stool tests. Separately, the group found that polyp detection rates at a first colonoscopy for average-risk adults 45 to 49 were comparable to those for adults 50 to 54, suggesting the earlier screening window catches meaningful disease.
Philadelphia also lost a resident to the disease in a case that resonates with lawmakers pushing this cause. State Representative Jordan Harris, who represents parts of West and Southwest Philadelphia, has described how his wife, Tiffany Harris, died from colon cancer at age 36 in 2024. Harris has said she might not have been considered high risk before her diagnosis, and that routine screening might have caught her cancer earlier. He has said no family in Pennsylvania should experience the pain of a cancer diagnosis going undetected too long.
Lawmakers Eye an Even Lower Screening Age
Gallagher and other Pennsylvania lawmakers and cancer survivors are already preparing to push the age threshold down further. He plans to introduce legislation next term lowering the recommended screening age by five more years, and has said getting the age down to 40 is important, while reaching 35 would be a major challenge. Dennis Massimo, a 43-year-old who received immunotherapy for colon cancer at Abramson Cancer Center West Chester, is among the patients whose experience has fueled that next push, according to WHYY's reporting by Nicole Leonard.
