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Assembly committee amends and releases three health‑coverage bills, including biomarker testing measure
Summary
The Assembly Financial Institutions and Insurance Committee amended and released A4027 (IVF genetic testing coverage), A4163 (insurance coverage for biomarker testing) and A4275 (maintenance‑medication continuity). A4163 drew extensive testimony from clinicians, patient advocates and insurers before passing out of committee.
The Assembly Financial Institutions and Insurance Committee on Wednesday amended and released three bills affecting health‑insurance coverage and pharmacy benefits.
The panel amended and released Assembly Bill 4027, which would require coverage of certain pre‑implantation genetic testing in in‑vitro fertilization under conditions set in the bill and committee amendments. The clerk reported written support from the Academy of Adoption and Assisted Reproductive Attorneys, Resolve and clinician Dr. Serena Chen and one opposed slip from James King of the New Jersey Catholic Conference. A committee member said they would ‘‘abstain at this time’’ to allow further review; the motion to amend and release was carried.
The committee also amended and released Assembly Bill 4163, a broader measure requiring insurers regulated by the state to provide coverage for biomarker testing when supported by medical and scientific evidence. Witnesses who urged passage included clinicians and patient advocates and representatives of the American Cancer Society Cancer Action Network and the Alzheimer’s Association. Dr. Amy Franco, a cancer researcher, described how biomarker testing can guide targeted therapies and help avoid ineffective treatments, and the Alzheimer’s Association noted the potential for earlier dementia detection to improve care planning. Quintin Law of the American Cancer Society Cancer Action Network said the bill covers testing "solely for the purpose of diagnosing, treating, managing, and monitoring an existing disease or condition," and does not mandate population screening.
Cost impacts were debated. Committee testimony cited a 2022 actuarial analysis from Milliman estimating a 14–51¢ per‑member‑per‑month effect for commercial plans and a 5–9¢ per‑member‑per‑month impact for Medicaid. Lawmakers pressed witnesses on whether coverage would save money long‑term; proponents argued it can reduce unnecessary tests and inappropriate treatments, while some insurer representatives urged narrow, evidence‑based coverage criteria and said many carriers already cover tests in appropriate cases.
The committee also released Assembly Bill 4275, which would prevent the State Health Benefits Program, School Employees’ Health Benefits Program and Medicaid from denying coverage for maintenance medications for chronic conditions solely because a covered person changed plans or pharmacy benefit managers. No witnesses testified in person; the clerk noted a support slip from CarePlus New Jersey and the committee approved the release.
Next steps: All three bills were released from committee and will proceed through the Assembly’s legislative process. A4163 and other measures referenced changes to prior authorization timelines enacted last year; committee members and witnesses said those forthcoming rules informed their deliberations.
"Passing this bill would ensure New Jersey patients covered by Medicaid and state‑regulated insurance plans have access to biomarker testing when it is supported by medical and scientific evidence," Quintin Law of the American Cancer Society Cancer Action Network said during testimony.
The committee did not take up A4953 (Patient and Provider Protection Act) for a vote; that measure was set for discussion only and prompted an extended hearing.
