During the 2026 legislative session, lawmakers considered a state-funded, 24-month cancer screening pilot program for active and retired career firefighters through SB 940, HB 5068, and the introduced version of HB 4989. The program would include a MCD test, ultrasound screening, low-dose CT, and skin cancer screening, with expenditures capped at $1,300 per participant. A fiscal analysis identified 562 active and 1,128 retired firefighters eligible for the program and estimated total costs at around $2.2 million, excluding administrative expenses.

Alternatively, HB 4627 and the committee substitute for HB 4989 proposed insurance-based coverage of cancer screenings recommended by International Association of Firefighters guidelines or National Fire Protection Association standards, respectively. It would require coverage of cancer screenings without cost-sharing, with an exception for deductibles under high-deductible health plans. The average cost of standard cancer screening is $180 per patient while other firefighter-oriented screening services not currently covered by the Public Employees Insurance Agency ranged from $900–$2,500. It was estimated HB 4627 would increase plan costs by approximately $56,000. However, the fiscal estimates for the pilot program and this insurance-based approach are not directly comparable because the proposals differ in eligible populations, covered tests, and funding mechanisms.

Approaches in Other States

States have used different approaches to expand cancer screening for firefighters. New Jersey requires periodic cancer screening for full-time paid firefighters every three years and may reimburse public employers up to $1,250 per firefighter. This is similar to the $1,300 per-person allocation proposed in SB 940 and HB 5068, but New Jersey has established screening as an ongoing occupational benefit. However, this program only applies to full-time firefighters.

Louisiana requires employers to fund periodic cancer screening to professional firefighters, with screening frequency increasing with age and continuing into retirement. Louisiana also limits insurer responsibility for screening performed more frequently than recommended by established cancer-screening guidelines.Like Louisiana, West Virginia’s SB 940 and HB 5068 would also have included retired firefighters. However, Louisiana assigns the ongoing cost to employers rather than establishing a state-funded program, which could have different fiscal effects across counties. 

States have also considered how to reach volunteer firefighters. Virginia’s proposed Firefighters Cancer Screening Grant Program would provide grants to localities for ultrasound and MCD screening but has not been enacted. In contrast, Nevada requires employer-funded annual screening for covered career and volunteer firefighters as of July 2026, while Wyoming provides screening through workers' compensation for career and volunteer firefighters with at least 10 years of service.

These approaches illustrate several policy options for West Virginia, including state funding, employer or insurance requirements, local grants, or workers' compensation benefits. Programs vary in whether they cover retirees or volunteers and whether they support established screening practices or emerging technologies such as MCD tests.