New Jersey 2024-2025 Regular Session

New Jersey Assembly Bill A5278

Introduced
2/10/25  
Refer
2/10/25  

Caption

Establishes "New Jersey Menopause Coverage Act"; requires health insurance coverage of medically necessary perimenopause and menopause treatments.

Impact

The enactment of A5278 would significantly expand the scope of health insurance coverage for women in New Jersey, addressing a gap in services commonly overlooked in women's health. This legislation aims to reduce the financial burden on women experiencing perimenopause and menopause by ensuring that they have access to a comprehensive range of treatments without undue financial strain. The requirement to cover preventative services related to menopause could lead to early detection and treatment of associated health conditions, such as osteoporosis and cardiovascular disease.

Summary

Assembly Bill A5278, also known as the New Jersey Menopause Coverage Act, is designed to mandate health insurance coverage for medically necessary treatments associated with perimenopause and menopause. The bill requires hospital service corporations, medical service corporations, and health maintenance organizations to provide coverage for various treatments, including hormone therapy, non-hormonal treatments, surgery, and preventative services related to menopause. Additionally, the bill ensures that covered individuals receive clear information regarding their rights and the treatments available under their insurance plans.

Sentiment

The sentiment surrounding A5278 is largely positive among advocates for women's health, as it represents a step towards acknowledging and addressing the healthcare needs of women navigating menopause. Supporters argue that the coverage mandate will empower women to seek necessary medical attention without fear of prohibitive costs, thus enhancing their quality of life. However, some concerns have been raised about potential increased insurance premiums and the impact on insurance service providers, which remains a point of discussion among stakeholders.

Contention

Notable points of contention regarding A5278 include the debate over the financial implications for insurance companies and the potential for increased premiums for policyholders. Critics argue that mandating extensive coverage for menopause-related treatments could lead to higher costs that might be passed on to consumers. Opponents also highlight the challenges of ensuring that all medical professionals are adequately trained in menopause management, which is crucial for the effective implementation of this legislation.

Companion Bills

NJ S4148

Same As Establishes "New Jersey Menopause Coverage Act"; requires health insurance coverage of medically necessary perimenopause and menopause treatments.

Similar Bills

NJ S4148

Establishes "New Jersey Menopause Coverage Act"; requires health insurance coverage of medically necessary perimenopause and menopause treatments.

NJ SJR85

Designates October of each year as "Menopause Awareness Month" October 11 of each year as "Perimenopause Day," and October 18 of each year as "Postmenopause Day" in New Jersey.

CA AB2467

Health care coverage for menopause.

LA HB392

Provides relative to Medicaid and private insurance coverage for perimenopausal and menopausal care (EN NO IMPACT See Note)

NJ AJR187

Designates October 18 of each year as "Postmenopause Day" in New Jersey.

NJ SJR114

Designates October 18 of each year as "Postmenopause Day" in New Jersey.

NJ SJR86

Designates October 18 of each year as "Postmenopause Day" in New Jersey.

NJ AJR124

Designates October 18 of each year as "Postmenopause Day" in New Jersey.