Prieto, Mukherji & Benson Bill to Expand Mammogram Insurance Coverage for Adopted Women Advanced by Assembly Panel

Legislation Assembly Speaker Vincent Prieto, Assemblyman Raj Mukherji and Assemblyman Daniel Benson sponsored to expand access to mammograms for adopted women in New Jersey was released Thursday by an Assembly panel.

The bill (A-1247) would require health insurers to provide benefits coverage for mammograms to women under age 40 who may be at risk for developing breast cancer but lack access to their family histories because either they or their parents were adopted. While current law requires insurers to cover mammograms for younger women with a demonstrable family history of breast cancer, the sponsors note that this burden of proof renders the exams less accessible to adopted women and the daughters of adopted parents.

“Women with a close relative who has had breast cancer are at twice the risk of having it themselves, which means family history is an essential element in the process of diagnosing and treating the disease,” said Prieto (D-Bergen/Hudson). “For the adoptees and children of adoptees who are without access to that information, this legislation has the potential to be life-saving.”

While medical professionals typically first offer mammograms to women at age 40, they recommend that those with a family history of breast cancer begin screenings 10 years prior to the age at which their relative was first diagnosed, which may be before 40, Prieto said.

The legislation would apply to health insurers including: health, hospital and medical service corporations; commercial individual, small employer and large group health insurers; HMOs; and the State Health Benefits Program.

“Our current system of tying a woman’s access to her family history to her access to the proper preventive care puts adopted women at a disadvantage that ultimately may be fatal,” said Mukherji (D-Hudson). “This bill is a major step toward ensuring that adopted women have access to diagnostic testing and potentially life-saving early treatment so that mothers, sisters and aunts all across New Jersey can enjoy time with their families long into the future.”

“Unfortunately, our conversations about breast cancer often presuppose that women know whether their mother or grandmother had the disease. This not only alienates adopted women but decreases the likelihood that they will seek a mammogram at the appropriate age,” said Benson (D-Mercer/Middlesex). “By requiring insurance companies to cover early screening for adopted women, we address a public health matter that today threatens the lives of women in New Jersey.”

The bill was released by the Assembly Financial Institutions and Insurance Committee.