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Bill

Bill

S 2716

Requires health insurers, SHBP, and SEHBP to cover mammograms for women over 35 and women under 35 under certain circumstances.

2026-2027 Regular Session Introduced by Britnee Timberlake

New Jersey bill expands mandatory insurance coverage of mammograms to all women over 35 and qualifying younger women, potentially increasing screening access but raising coverage costs.

Introduced in the Senate, Referred to Senate Commerce Committee
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Bill Summary · S 2716

Legislative bill overview

S 2716 mandates that health insurers, the State Health Benefits Plan (SHBP), and the School Employees' Health Benefits Plan (SEHBP) in New Jersey cover mammograms for all women over 35 and for women under 35 meeting certain clinical criteria. The bill expands mammography coverage requirements beyond current standards to ensure broader access to breast cancer screening.

Why is this important

Early breast cancer detection through mammography significantly improves treatment outcomes and survival rates. This bill could increase preventive screening access across a large population, potentially catching cancers earlier. However, it also affects insurance costs and may impose coverage mandates that reshape premium pricing and plan design.

Potential points of contention

  • Age 35 threshold debate: Major medical organizations (USPSTF, ACS) typically recommend routine mammograms starting at age 40-50 for average-risk women; mandating coverage at 35 may exceed evidence-based guidelines and increase unnecessary screening in lower-risk populations
  • Cost implications: Expanded coverage increases insurance claims and administrative costs, which may raise premiums for employers and individual policyholders across SHBP and SEHBP plans
  • "Certain circumstances" undefined: The bill's language for women under 35 lacks specificity about which clinical criteria qualify, creating ambiguity for insurers and potential coverage disputes

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

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