Office of Legislative Services
State House Annex
P.O. Box 068
Trenton, New Jersey 08625
Legislative Budget and Finance Office
Phone (609) 847-3105
Fax (609) 777-2442
www.njleg.state.nj.us
LEGISLATIVE FISCAL ESTIMATE
[First Reprint]
ASSEMBLY, No. 1996
STATE OF NEW JERSEY
221st LEGISLATURE
DATED: JANUARY 30, 2025
SUMMARY
Synopsis: Establishes requirements to screen certain people who are pregnant
and who have given birth for preeclampsia.
Type of Impact: Annual State cost increases; annual State revenue increase; annual cost
increase to University Hospital.
Agencies Affected: Department of Health, Department of Human Services, Department of
Law and Public Safety, University Hospital.
Office of Legislative Services Estimate
Fiscal Impact
Annual State Cost Increase-Educational
Campaign $100,000
Annual State Cost Increase-NJ FamilyCare Indeterminate
Annual State Revenue Increase Indeterminate
Annual Cost Increase to University Hospital Indeterminate
The Office of Legislative Services (OLS) concludes that this bill would increase annual State
costs by about $100,000 annually for the Department of Health and the State Board of Medical
Examiners to develop and distribute educational materials on hypertensive disorders related to
pregnancy that certain healthcare facilities and providers are to provide pregnant persons or
persons who have recently given birth. This amount is comparable to what the State has spent
on the stillbirth prevention public health campaign in each of the three years through FY 2025.
Moreover, to the extent that individuals covered under NJ FamilyCare, the State’s Medicaid
program, receive additional or more intensive treatment, NJ FamilyCare expenditures would
increase by an indeterminate amount annually. These expenditures would be eligible for
additional federal Medicaid matching funds, thereby increasing State revenues by an
indeterminate amount.
There is the potential for annual cost savings under the NJ FamilyCare program if the bill’s
requirements were to cause positive health outcomes that reduce future treatment costs. FE to A1996 [1R]
2
University Hospital, an independent non-profit legal entity that is an instrumentality of the
State, would incur an indeterminate increase in costs to comply with the requirements
established under this bill.
BILL DESCRIPTION
The bill directs licensed hospitals and birthing centers, federally qualified health centers, and
health care practitioners providing care to a pregnant person or to a person who has given birth
within the prior 12 weeks, to adopt and adhere to policies requiring the person to be screened for
pregnancy-related hypertensive disorders, including postpartum preeclampsia and hypertension, if
the person shows symptoms of the condition and has not in the current or recent pregnancy been
diagnosed with the condition, or currently is experiencing symptoms.
These facilities and health care practitioners are required to provide the person with educational
information on pregnancy-related hypertensive disorders and the potential warning signs and
symptoms of these disorders; inform the person of the benefits of being screened for such disorders
if the person develops any symptoms and that the person should be screened unless the person
declines; and inform the person of the benefits of routine home blood pressure monitoring. The
department and the State Board of Medical Examiners are to develop and distribute the required
educational information to all hospitals, birthing centers, federally qualified health centers, and
health care practitioners who treat pregnant and postpartum persons.
FISCAL ANALYSIS
EXECUTIVE BRANCH
None received.
OFFICE OF LEGISLATIVE SERVICES
The OLS concludes that this bill would increase annual State costs by about $100,000 annually
for the Department of Health and the State Board of Medical Examiners to develop and distribute
educational materials on hypertensive disorders related to pregnancy that certain healthcare
facilities and providers are to provide pregnant persons or persons who have recently given birth.
This amount is comparable to what the State has spent on the stillbirth prevention public health
campaign in each of the three years through FY 2025. These amounts may vary year-to-year based
on need or as best practices are updated and new materials are developed and disseminated.
Moreover, to the extent that individuals covered under NJ FamilyCare, the State’s Medicaid
program, receive additional or more intensive treatment because of the new educational campaign
and the bill’s requirement that certain healthcare facilities and practitioners adopt and adhere to
policies requiring screenings for hypertensive disorders related to pregnancy, NJ FamilyCare
expenditures would increase by an indeterminate amount annually. The OLS lacks the
informational basis to determine how demand for screenings may change as a result of the bill and
how much the associated State costs would increase. However, increased NJ FamilyCare
expenditures would be eligible for additional federal Medicaid matching funds, thereby increasing
State revenues annually, albeit by an indeterminate amount. The OLS also notes that there is the FE to A1996 [1R]
3
potential for annual cost savings under the NJ FamilyCare program if the bill’s requirements were
to cause positive health outcomes that reduce future treatment costs.
University Hospital, an independent non-profit legal entity that is an instrumentality of the
State, would also incur an indeterminate increase in annual costs to the extent it provides additional
or more intensive treatment to patients because of the required educational campaign and the
requirement that it adopt and adhere to policies requiring screenings for hypertensive disorders
related to pregnancy. The OLS cannot surmise how much demand for screenings and treatment
would increase in response to the bill to determine the magnitude of the hospital’s cost increases.
By way of context, New Jersey has 71 State-licensed hospitals and 23 federally qualified health
centers that would be affected by the bill. Data from the New Jersey State Health Assessment
Data set show that there were 102,890 births to New Jersey residents in 2022, the most recent year
for which data are available. Of this total number, approximately 30 percent, or 30,999 births in
2022, were covered by the Medicaid program. According to the Preeclampsia Foundation,
hypertensive disorders of pregnancy affect between five and eight percent of all births in the United
States; moreover, the foundation reports that the rate of preeclampsia in the Unites States has risen
by 25 percent over the past 20 years.
Section: Human Services
Analyst: Anne Cappabianca
Senior Fiscal Analyst
Approved: Thomas Koenig
Legislative Budget and Finance Officer
This legislative fiscal estimate has been produced by the Office of Legislative Services due to the
failure of the Executive Branch to respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).