NJ bill will make insurance cover early detection of disease
By: Scot Fallon
NorthJersey.com
USA Today Network - New Jersey
..... When Doreen Monks was diagnosed with early-onset Alzheimer's disease in 2015. she was told to get her affairs in order since the average lifespan from diagnosis to death was nine years.
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"I went form having a great job and a good income to losing my job, losing 70% of my income, my home," said Monks, the former program director for the stroke center at St. Barnabas Medical Center.
..... But when she entered a clinical trial for an Alzheimer's drug, APET scan of the brain did not detect the amyloid plague that damages nerve cells and leads to the disease. She had mild cognitive impairment, not Alzheimer's.
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Monks told her story to Trenton lawmakers last week [10/24/2024] to persuade them to increase access to bio-maker testing that could lead to early detections and more targeted treatments for a range of disease from Alzheimer's to cancer.
..... "I look at how different my life would have been had the bio-maker been available nine years ago," Monks said. "And I don't want anybody else to go through that."
..... The bill which was advanced unanimously by a legislative committee last week, [10/24/2024] would require all health insures to cover bio-maker testing where tissue, blood, or other specimens are examined for a substance such as certain proteins, genes or hormones that are a tell-tale sign for a disease or condition.
..... Testing would only be covered by insurance for "diagnosis, treatment, appropriate management, or ongoing monitoring of an individual's disease."
..... The bill - A4163 - has the backing of advocacy groups including the Alzheimer's Association, the American Cancer Society and the National Multiple Sclerosis Society, all of which had members telling the Assembly Financial Institutions and Insurance committee on Thursday [10/24/2024] why it should become law.
..... Among them was breast cancer survivor Jeanelle Adams of Newark. She told the committee that it took at least 15 months for her to be diagnosed with state three triple negative breast cancer at age 33 in 2022 after she began noticing rashes, leaks and lumps on her breast.
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Adams said her oncologist suggested bio-maker testing to develop a targeted treatment.
..... Her private insurance plan covered the testing. She went through 23 rounds of chemotherapy and had a double mastectomy. I worked. Adams had been in remission for a year.
..... "Without bio-marker testing, I wouldn't likely be here to share my story," she told the committee.
May cost more up front, but savings long term
..... Those in favor of the bill say bio-marker testing may cost more upfront but savings will come in the long run because the treatment plans will be better, shorter and sue less resources. A report commissioned by the American Cancer Society found that 90% of insures covered some portion of bio-maker testing but the level of coverage varied widely.
..... Fifteen states requires all private and public insurers to cover bio-maker testing, including New York and Pennsylvania, according to the American Cancer Society. Dr, Amy Franco, director of Center for Childhood Cancer Research at Children's Hospital of Philadelphia, told the committee that her Pennsylvania patients have benefited form this coverage. She wants all New Jersey patients coved too.
..... "It is unacceptable that any patient should be denied access to these advancements because of coverage issues," she said.
..... The bill has bipartisan support, but still has a way to go to become law. It will now be considered by the Assembly Appropriations Committee. A sister bill in the Senate -S3098 - was introduced in April [2204] but no committee hearing has yet taken place.