In an effort to streamline access to critical health care services and prescription
medications while enhancing New Jersey’s health care workforce, Gov. Phil Murphy
last week signed four bills to make health care more accessible and affordable.
“When people cannot access health care, small problems can turn into debilitating
crises,” he said. “That is why my Administration has spent the past eight years laser
focused on expanding access to critical health care services – and making those
services more affordable so our residents don’t have to choose between seeking out
care and paying their bills.
“Today, we are building on our efforts to reinvent our health care system. With these bill
signings, we are breaking down barriers that prevent New Jerseyans from accessing
affordable health care services and prescription medications, including for menopause
treatment and HIV prophylaxis, along with bolstering our physician assistant workforce.”
The first bill (S2019/A6293) authorizes pharmacists to dispense HIV prophylaxis – a
course of treatment involving certain drugs or drug combinations, such as HIV
preexposure prophylaxis (PrEP) and HIV postexposure prophylaxis (PEP), that can
prevent HIV infection. The legislation also mandates prescription benefits coverage for
PrEP and PEP under health benefits plans that include prescription benefits, as well as
the State Employees’ Health Benefits Plan, the School Employees’ Health Benefits
Plan, and Medicaid. The Murphy Administration has prioritized ending the HIV epidemic.
As the State strives to reduce HIV infections, this bill will put prevention medications
within reach of communities.
The second bill (A5217/S3818) prohibits the use of “copay accumulators” – a process
used by insurance companies and Pharmacy Benefit Managers that prevents
manufacturer copay assistance coupons from counting towards a patient’s out-of-pocket costs for covered benefits. This builds on other efforts by the Murphy Administration to reduce out-of-pocket costs. For example, through the Office of Health Care Affordability
and Transparency in partnership with the Department of Banking and Insurance, the
Murphy Administration has capped costs for insulin, asthma inhalers, epinephrine,
hearing aids, and cochlear implant purchases.
The third bill (A5278/S4148), also known as the New Jersey Menopause Coverage Act,
addresses a long-overlooked health concern for women by establishing health
insurance coverage requirements for medically necessary perimenopause and
menopause treatment. Under the legislation, health insurance carriers will be required
to cover medically necessary treatment for women with a diagnosis of perimenopause or menopause, including hormonal and non-hormonal therapies, pelvic floor physical
therapy, bone health care, preventive care, and patient education. The Murphy
Administration has focused on women’s health concerns — from supporting menstrual
equity to protecting reproductive freedom to making maternal health safer to, now,
ensuring coverage of menopause care.
The fourth bill (A4328/S3560) enters New Jersey into the Interstate Physician Assistant
Licensure Compact, an interstate agreement that allows physician assistants (PAs) to
practice in multiple states without needing separate licenses for each state. Under the
legislation, participants would have to meet New Jersey’s licensing requirements.
The bills were applauded by the leaders of numerous health care organizations. Among
them:
Cathy Bennett, CEO, NJHA: “New Jersey hospitals are committed to high-quality,
affordable care for every New Jerseyan. The New Jersey Hospital Association, together
with our members, have been active partners in the state’s healthcare affordability work.
The HART reports released today show that New Jersey is experiencing inflation-driven
cost growth while continuing to deliver high-quality care and performing better than
many peer states. The findings reinforce the need for a measured, systemwide
approach to healthcare affordability.
Chrissy Buteas, CEO, HealthCare Institute of New Jersey: “Copay accumulator
programs punish patients for accepting assistance from biopharmaceutical companies
by preventing it from counting toward their out-of-pocket limits, forcing them to pay their
deductible twice. Today’s enactment will protect those patients when a manufacturer
helps to make their prescription more affordable.”
Debbie Hart, CEO, BioNJ: “BioNJ thanks Governor Murphy for the signing of
legislation that will ensure that Patients receive the cost assistance intended for them.
With these new policies, the Governor and Legislature have made significant progress
towards achieving greater access and affordability for patients.”
