North Carolina SB 522: Thrive at Midlife Act.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 522

Short Title: Thrive at Midlife Act. (Public)
Sponsors: Senator Theodros (Primary Sponsor).
Referred to: Rules and Operations of the Senate
March 26, 2025
*S522-v-1*
A BILL TO BE ENTITLED 1
AN ACT EXPANDING ACCESS TO AFFORDABLE, COMPREHENSIVE HEALTHCARE 2
FOR WOMEN IN MIDLIFE THROUGH IMPROVED HEALTH INSURANCE AND 3
MEDICAID COVERAGE; PROGRAMS TO EXPAND ACCESS TO ESSENTIAL 4
MIDLIFE HEALTHCARE SERVICES; TAX CREDITS FOR INDIVIDUALS AND 5
BUSINESSES FOR MIDLIFE HEALTHCARE EXPENSES; EXPANDED ACCESS TO 6
PROVIDERS TRAINED IN ESSENTIAL MIDLIFE HEALTHCARE SERVICES; 7
PUBLIC AWARENESS AND OUTREACH; BETTER DATA COLLECTION AND 8
OVERSIGHT; ESTABLISHMENT OF A MIDLIFE HEALTH ADVISORY COUNCIL; 9
AND APPROPRIATING FUNDS FOR THESE PURPOSES. 10
Whereas, women in midlife (ages 40-65) face unique healthcare challenges, including 11
menopause-related conditions, increased risk of chronic diseases, and barriers to affordable 12
healthcare access; and 13
Whereas, improving access to midlife healthcare services will enhance quality of life, 14
reduce long-term healthcare costs, and promote preventive care for women in North Carolina; 15
and 16
Whereas, it is the policy of the State of North Carolina to promote public health and 17
equitable healthcare access; Now, therefore, 18
The General Assembly of North Carolina enacts: 19
20
PART I. TITLE 21
SECTION 1.1. This act shall be known as "The Thrive at Midlife Act." 22
23
PART II. DEFINITIONS 24
SECTION 2.1. The following definitions apply in this act: 25
(1) Essential midlife healthcare services. – Includes, but is not limited to, all of 26
the following: 27
a. Menopause-related care and hormone therapy. 28
b. Osteoporosis screenings. 29
c. Cardiovascular disease prevention. 30
d. Diabetes screenings and management. 31
e. Mammograms and cervical cancer screenings. 32
f. Mental health and wellness programs. 33
g. Telehealth services for midlife-specific conditions. 34
(2) Midlife women. – Individuals assigned female at birth or who identify as 35
women and who are at least 40 but less than 65 years of age. 36

General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 522-First Edition
1
PART III. EXPANDED COVERAGE REQUIREMENTS 2
3
INSURANCE MANDATES 4
SECTION 3.1.(a) Article 3 of Chapter 58 of the General Statutes is amended by 5
adding a new section to read: 6
"§ 58-3-305. Coverage required for essential midlife healthcare services. 7
(a) All health benefit plans shall include coverage for essential midlife healthcare 8
services for individuals who either (i) were assigned female at birth or (ii) identify as a woman 9
and who are at least 40 years of age but less than 65 years of age. 10
(b) Essential midlife healthcare services required to be covered under this section include 11
all of the following: 12
(1) Menopause-related care and hormone therapy. 13
(2) Osteoporosis screenings. 14
(3) Cardiovascular disease prevention. 15
(4) Diabetes screening and management. 16
(5) Mammograms and cervical cancer screenings. 17
(6) Mental health and wellness programs. 18
(7) Telehealth services for midlife-specific conditions. 19
(c) Any cost-sharing requirements, including copayments and deductibles, for essential 20
midlife healthcare services shall not exceed those established for preventative services under the 21
Patient Protection and Affordable Care Act, P.L. 111-148, as amended, or other applicable 22
federal law." 23
SECTION 3.1.(b) The Department of Health and Human Services, Division of 24
Health Benefits, shall ensure coverage for essential midlife healthcare services, as described in 25
G.S. 58-3-305(b), for Medicaid recipients who either (i) were assigned female at birth or (ii) 26
identify as a woman and who are at least 40 years of age but less than 65 years of age. 27
SECTION 3.1.(c) Subsection (a) of this section is effective October 1, 2025, and 28
applies to insurance contracts issued, renewed, or amended on or after that date. The remainder 29
of this section is effective when it becomes law. 30
31
MIDLIFE HEALTH ACCESS PROGRAM 32
SECTION 3.2.(a) Effective July 1, 2025, there is appropriated from the General 33
Fund to the Department of Health and Human Services, Division of Central Management and 34
Support, Office of Rural Health (ORH), the sum of ten million dollars ($10,000,000) in recurring 35
funds for each year of the 2025-2027 fiscal biennium to establish a Midlife Health Access Grant 36
Program (Program). The purpose of the Program is to provide directed grants on a competitive 37
basis to federally qualified health centers, rural health clinics, community-based nonprofit 38
organizations, and other safety-net providers that are capable of providing essential midlife 39
healthcare services to midlife women who are uninsured regardless of their ability to pay. 40
SECTION 3.2.(b) The ORH shall develop application materials and selection 41
criteria for the Program. The selection criteri