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Bill

Bill

S 1275

Requires health insurance coverage of diagnostic and supplemental breast examinations without cost-sharing.

2026-2027 Regular Session Introduced by Jim Beach and 6 co-sponsors

New Jersey bill requires insurance plans to cover diagnostic and supplemental breast exams with zero patient cost-sharing, increasing access but potentially raising premiums statewide.

Introduced in the Senate, Referred to Senate Commerce Committee
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Bill Summary · S 1275

Legislative bill overview

S 1275 mandates that health insurance plans in New Jersey cover diagnostic and supplemental breast examinations (such as ultrasounds and MRIs) without any patient cost-sharing—meaning no copays, coinsurance, or deductibles. The bill applies to all health insurance policies issued or renewed in the state.

Why is this important

Breast cancer is a leading cause of cancer mortality, and supplemental imaging can detect cancers missed by standard mammograms, particularly in women with dense breast tissue. Removing financial barriers to these examinations could increase screening rates and enable earlier detection, though it also increases insurance costs that may be passed to consumers through higher premiums.

Potential points of contention

  • Cost impact: Eliminating cost-sharing increases overall healthcare spending, which insurers typically offset through premium increases affecting all policyholders, including those who don't use these services
  • Medical necessity criteria: The bill doesn't specify which patients qualify for "supplemental" imaging, creating potential disputes over coverage eligibility and utilization management
  • Existing coverage gaps: Diagnostic imaging is often already covered; the main change concerns supplemental exams, raising questions about whether the cost burden truly prevents access or if other factors limit screening uptake

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

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