Alabama has long struggled with poor health outcomes, ranking among the worst states in maternal health, infant mortality, and access to quality healthcare. Now, advocates say lawmakers have a chance to change that narrative — by eliminating out-of-pocket costs for prostate cancer screenings.
Prostate cancer is the second leading cause of cancer deaths among men in the United States, and early detection is often the difference between life and death. Yet for many men in Alabama, the cost of screening remains a significant barrier.
“Any excuse is a good excuse, right? So, if the test is free there’s no excuse,” said Rep. Jeremy Gray (D-Opelika). “No cost to get this done. No deductible. No copay. No co-insurance. Basically, taking all of that out of the process.”
Eight states currently mandate free prostate-specific antigen (PSA) screenings for men at higher risk of developing prostate cancer. Those considered high risk include men over 40, African American men — who face disproportionately higher rates of both diagnosis and mortality — and men with a family history of the disease.
During the 2025 legislative session, Sen. Steve Livingston (R-Scottsboro) introduced SB190, which would have eliminated the cost of PSA tests for at-risk men. Rep. Gray carried the companion bill, HB334, in the House. Both measures gained bipartisan support and passed key committees, with backing even from major insurers. The Senate approved its version unanimously, 33-0.
Despite momentum, HB334 stalled before the session ended, leaving Alabama behind neighboring states. In 2024, Kentucky and Tennessee enacted similar laws, followed by Delaware and Virginia, bringing the total to nine states with free screening policies. Alabama missed the opportunity to become the 10th.
For patients, the stakes are personal. Early detection saved the life of one Alabama man, who shared his recent diagnosis of intermediate-risk prostate cancer. Because of his family history — his father died of the disease — he received annual screenings that led to early identification. Without those tests, he says, his story might have been very different.
Advocates argue that eliminating financial barriers could encourage more men to get tested, saving lives across the state. With the 2026 legislative session approaching, pressure is mounting on Alabama lawmakers to act.
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