Health Insurance - Genetic Testing and Cancer Imaging - Required Coverage
Summary
HB830 requires certain Maryland health insurers, nonprofit health service plans, and health maintenance organizations to cover specified genetic testing and follow-up cancer imaging for individuals with a personal or family history of cancer who may be at increased risk of developing cancer. The genetic testing must be recommended by a health care professional and consistent with evidence-based clinical practice guidelines. If the testing shows an increased cancer risk, the bill also requires coverage for follow-up imaging recommended for the identified cancer type and aligned with the most recent National Comprehensive Cancer Network guidelines.
The bill also bars covered entities from imposing copayments, coinsurance, or deductibles on the required genetic testing and follow-up imaging, with limited exceptions for health savings account-qualified high deductible health plans to the extent needed to preserve federal tax treatment. Preventive care services that qualify under federal law are exempt from cost-sharing restrictions regardless of whether the beneficiary has met the minimum deductible. The new coverage requirements apply to policies, contracts, and health benefit plans issued, delivered, or renewed on or after January 1, 2026.
Impact
HB830 adds a new Section 15-861 to the Maryland Insurance Article, expanding mandated health insurance benefits for cancer-related genetic testing and imaging. It affects insurers, nonprofit health service plans, and HMOs operating in Maryland by requiring coverage of certain preventive and diagnostic services and limiting out-of-pocket costs for patients. The bill is prospective, applying to plans renewed or issued on or after January 1, 2026, and includes a federal-law accommodation for health savings account-qualified high deductible health plans.
Sentiment
The bill appears to have strong support in the House, passing third reading by a wide margin of 134 yeas to 1 nay. The sponsor list is broad and bipartisan, suggesting substantial agreement that reducing financial barriers to genetic testing and cancer surveillance is a public health priority. No committee transcript was provided, but the favorable committee report and overwhelming floor vote indicate generally positive sentiment.
Contention
The main policy issue is the mandate itself: insurers and health plans must cover genetic testing and follow-up imaging without standard cost-sharing, which can raise concerns about premium impacts and the scope of required benefits. A narrower technical point is the interaction with federal health savings account rules, which the bill addresses by limiting how the no-cost-sharing requirement applies to HSA-qualified high deductible health plans. The near-unanimous vote suggests little recorded opposition, with only one nay on final passage.