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Bill

SB 554

AN ACT REQUIRING HEALTH INSURANCE COVERAGE FOR BIOMARKER TESTING.

2025 Regular Session Introduced by Saud Anwar

Connecticut would require health insurers to cover biomarker testing, expanding access to disease detection but increasing insurance costs and creating coverage definition disputes.

REF. TO JOINT COMM. ON Insurance and Real Estate
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Bill Summary · SB 554

Legislative bill overview

SB 554 would require health insurance plans in Connecticut to cover biomarker testing—laboratory tests that identify biological markers indicating disease risk, presence, or prognosis. The bill mandates insurance coverage without specifying which biomarkers, testing types, or clinical contexts qualify, leaving implementation details to regulation or insurer interpretation.

Why is this important

Biomarker testing can enable early disease detection and personalized treatment, potentially improving health outcomes and reducing downstream costs. However, insurance coverage requirements directly affect premium costs, insurer profitability, and healthcare spending—ultimately passed to consumers or taxpayers depending on the insurance type.

Potential points of contention

  • Scope ambiguity: The bill doesn't define which biomarker tests must be covered, creating uncertainty about cost implications and potential for disputes between insurers and patients over medical necessity
  • Cost and affordability: Mandatory coverage expands insurer obligations, which may increase premiums for all Connecticut residents or reduce insurer participation in the state market
  • Medical necessity standards: Unclear whether coverage applies only to FDA-approved tests with clinical evidence or broader categories, affecting both access and appropriate utilization

Compiled from official sources — confirm details with the bill’s official record.

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