Bipartisan legislation prefiled for the Alabama Legislature’s 2026 session is seeking to ensure prostate cancer screening access for at-risk populations.
Senate Bill 19, sponsored by Senate Majority Leader Steve Livingston, R-Scottsboro, and House Bill 40, sponsored by Representative Jeremy Gray, D-Opelika, would require prostate cancer screenings for at-risk men be fully covered by insurance providers, without deductibles, copayments or other cost-sharing requirements.
The bills recognize that regardless of age, African-American men, alongside men with a first degree relative who has had prostate cancer are at a higher risk for the disease.
The legislation would require free screenings for African American men, men over 50, men with a first degree relative who has been diagnosed with or died from prostate cancer or a cancer associated with a higher risk of prostate cancer and men who otherwise carry a genetic marker associated with increased risk of prostate cancer.
Screenings covered by the legislation include prostate-specific antigen blood tests for the early detection of prostate cancer and rectal examinations.
The two bills were prefiled in September in honor of Prostate Cancer Awareness Month.
Livingston told APR he was inspired to introduce legislation to improve access to prostate cancer screenings, after speaking with a Huntsville constituent who had been impacted by the disease and described his bill as an opportunity to make sure all Alabamians have access to screenings.
“This can help protect our friends, our family, our members. This is pretty widespread cancer,” Livingston said. “[Prostate cancer’s] impacted somebody you know. Since last year, here locally, my chamber director here has been impacted by this and is battling this.”
The pair of bills have seen endorsements from the American Cancer Society Cancer Action Network, ACS CAN, as well as national prostate cancer awareness and prevention nonprofit, ZERO Prostate Cancer.
Gray said he became involved in the legislation following a meeting ZERO Prostate Cancer coordinating with Congressional leaders, including by his chief of staff and Livingston.
“Senator Livingston was carrying it in the Senate, and they wanted someone to carry it in the house, to be bipartisan, and since I sit on the health committee, I was approached about kind of have a companion bill in the House,” Gray said.
ACS CAN Government Relations Director for Alabama Jane Adams expressed support for the bills’ emphasis on reducing financial barriers to screenings in order to improve early detection in at risk populations.
“Cancer doesn’t discriminate, but we know that there’s family history and there are certain things that predispose people to certain types of cancer,” Adams said. “So, we want to make sure that early detection tools are available and affordable for that population.”
“The PSA screening test, the blood screening test, we want to make sure that that’s affordable and available specifically to populations that are more at risk of developing prostate cancer, Black men and those who have a family history of the illness,” she added.
Adams emphasized the importance of early detection in cancer treatment, especially for patients with prostate or breast cancer, which are some of the most commonly contracted cancers and typically respond well to treatment when diagnosed early in their progression.
“We know that when people face financial barriers to early detection screening tools like the PSA antigen test, that they’re less likely to get them,” she said.
“It’s so very important that if we’re going to stop cancer, if we’re going to address coverage issues with, you know, getting these tests that we have to make sure they’re affordable and making sure that insurance companies, state regulated insurance companies, not only provide access to them, but cover them and eliminate cost sharing burdens, so making these tests available specifically to high risk populations,” Adams continued.
She went on to cite that, as of 2025, nine U.S. states have passed legislation to eliminate or reduce cost-sharing requirements for prostate cancer screenings.
“ZERO is deeply grateful for Senator Livingston’s unwavering advocacy on behalf of his constituent, David, and for his leadership in driving this critical effort forward,” said President and CEO of ZERO Prostate Cancer Courtney Bugler in a written statement.
“We also thank Senator Livingston and Representative Gray for championing the reintroduction of this vital legislation. Now we urge Alabama lawmakers to stand with men and families who need them most by ensuring its passage next year,” he added.
When asked to describe why they believed state legislators should support the bills, Livingston and Gray both emphasized that supporting the legislation would give lawmakers on both sides of the aisle a chance to improve healthcare access for at risk individuals.
“When you think about it, prostate cancer affects everyone, whether you are a victim of it, you’re someone who’s been a character, a caretaker, a sibling, or a significant other,” Gray said.
“I think it’s something that it goes past party lines. It goes past race. I just think this is a good piece of legislation for Alabama, Alabamians in general, and I think it’s a step to other things that we can see, as far as the screening process and taking away that cost that we can build upon. I think this is just the first step,” Gray continued.
“This isn’t a partisan issue, Livingston said. “This is, this is about your health, my health and their health, and taking care of everybody. Again, early screen and early detection, you have good opportunity to get rid of this cancer.”
Livingston’s version of the legislation came close to enactment in the 2025 legislative session, passing in the Senate, but failing to see a vote in the House before the session concluded.
Both lawmakers emphasized the bipartisan support the bills received last session and their hopes prefiling the bills early for 2026 would help the legislation secure enactment.
“Last year, we got down to the minute and just ran out of time, and so I just prefiled it this year to just get everybody talking about earlier,” Livingston said.
“No one had any real opposition against the bill,” said Gray. “It wasn’t like a significant blow to the general fund budget. So, once I talked to the general fund budget chair and a few other people then everybody was on board with the deal, Blue Cross, Blue Shield, everybody.”
Gray said although both bills received widespread support, the legislation was among a number of bills that were slowed late in the session due to disagreements between House and Senate leaders.
“The bill kind of sailed through the Senate, and the House version kind of went seamlessly through the insurance committee. But it was around the time where the Senate and the House were kind of engaging in, I guess, like kind of conflict,” he said. “All it needed to do was take a vote on the floor with, I think it was maybe a week or two left, and it just didn’t move.”
“I suspect that it’s gonna have, you know, a pretty good chance of passing next session,” Gray added.
According to ACS, roughly one in eight men will be diagnosed with prostate cancer during their lifetime. Prostate cancer is the second-leading cause of cancer deaths for men in the U.S., after lung cancer, however most men diagnosed with the disease survive with treatment.
The organization estimates that 5,440 Alabamians will contract the disease in 2025, more individuals than any other type of cancer.
The Alabama Legislature’s 2026 session is set to begin on January 13, 2026.
