You can save lives, Alabama lawmakers. Make prostate cancer screenings free.

Roy S. Johnson

This is an opinion column.

Rarely does Alabama have the opportunity to crash the top 10 among states in anything — unless we’re talking football and faith, of course. And food.

Certainly not in education (though props to educators and students statewide for the rise in test scores). Certainly not in access to quality healthcare with so many rural hospitals dying or on life support; maternal health or infant mortality, where we’re dead last.

Saving lives just doesn’t seem to be our thing, sadly.

Alabama lawmakers can — must — alter that egregious narrative in 2026. They can and must save lives — the lives of Alabama men facing prostate cancer.

Men who may not get tested for the disease because of cost or lack of insurance.

Men not as fortunate as me. Late last month, I told you about my prostate cancer diagnosis and my confidence that I’ll beat it — call it chapter one of my Cancer Chronicles.

My confidence in the prognosis in this battle is rooted in my faith and the blessing of early detection. Because my father died of prostate cancer when I was 11 years old, I’ve gotten annual checkups throughout adulthood. They included that, uh, inconvenient digital prostate exam and, for the last few years, a blood test to measure the level of prostate-specific antigen (PSA) protein coursing through my veins. An elevated PSA can be a red flag for a few things no man wants, including prostate cancer.

In May, following my latest routine exam with my primary care doctor, I was told my PSA had spiked from the prior test. The result: I have cancer: unfavorable intermediate risk, is how my urologist terms it.

We’re still digesting and ruminating over treatment options, though we’re, once again, confident all things will work together for good. Because God is in control and because I got regular early tests.

Not every man does, for myriad reasons. One of them being cost. Alabama lawmakers can — must — eliminate that 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.”

Currently, eight states have laws making PSA tests free for men with a high risk for prostate cancer. Alabama could’ve cracked the Top 10, but, once again, our lawmakers couldn’t get out of their own way.

During the 2025 legislative session, state Sen. Steve Livingston, R-Scottsboro, sponsored SB190, which would have made PSA testing free for those at heightened risk: men over 40, African American men (who are diagnosed with and die from prostate cancer at a far higher rate than white men) and anyone with a direct relative (father, brother) with prostate cancer.

In the House, Gray authored companion bill HB334 and was poised to shepherd it through the lower chamber. It was passed through the House Health committee, upon which Gray serves, and received the blessing of the Insurance committee.

“There wasn’t really any opposition,” Gray told me. “Blue Cross-Blue Shield, and all those people were for the bill. I had brought it before the Senate insurance committee. So, when it got to the House committee, they said, ‘We already heard it before and were gonna pass it through.’”

In April 2024, Kentucky Gov. Andy Beshear signed into law the state’s version of the law eliminating out-of-pocket costs for high-risk men being screened for prostate cancer and other cancer screenings. A month later, Tennessee Gov. Bill Lee signed the state’s “PSA Screening For HIM” bill into law. They became the sixth and seventh states to erase the cost of prostate cancer screenings for high-risk men, according to Zero Prostate Cancer, a national advocacy group.

Last fall, Delaware became No. 8 among states with a free screening law. In March, Virginia lawmakers made theirs the ninth state to enhance free prostate cancer screening laws.

We could have been No. 10. Should have been.

In Alabama, SB190 passed the Senate 33-0, but HB334 stalled. It was late in the session, but not too late.

“It just didn’t move anywhere,” Gray said. They let the clock run out.

In a text message, Livingston said plans to drop the bill ahead of the 2026 legislative session. Gray will do the same by pre-filing a House bill.

“This isn’t the first year I carried the bill,” texted Livingston. Adding that he champions the bill to “broaden screening.”

“I took the initiative to get an early start on it so we have time to pass,” Gray said. “I’m hoping Sen. Livingston will do the same thing, and we could get this passed through the House and the Senate for the next session.”

Why didn’t it pass this year? “Late in the session,” Livingston responded.

Think of how many lives could have been saved since then had the bill been passed and signed into law by Gov. Kay Ivey.

Cancer knows no political aisle, no left nor right. Only live (early detection) or die.

This year, the American Cancer Society estimates there will be about 5,440 new cases of prostate cancer; 550 of those men will die from the disease. That’s 550 sons, fathers, brothers, uncles…500 lives that might have been saved.

“Screening, early detection and treatment are critical to saving lives, “Rep. Neil Rafferty, D-Birmingham, said. “This is just what this law will accomplish.”

Yes, it will — if saving lives is our thing.

It must be our thing.