New Jersey's Biomarker Mandate Burdens Families With Shocking Costs

New Jersey’s latest healthcare mandate, signed into law on April 23, 2025, forces insurance providers, Medicaid, and public employee plans to cover biomarker testing. Supporters hail it as a leap toward personalized medicine, claiming it will save lives by tailoring treatments for diseases like cancer. But this well-intentioned policy comes with a steep price, one that families across the state will bear through higher premiums and fewer choices. The law, championed by Senators Vin Gopal and Troy Singleton alongside Assembly members Shavonda Sumter, Gary Schaer, and Shama Haider, prioritizes flashy innovation over practical affordability, a misstep that could strain wallets and erode trust in the healthcare system.

Biomarker testing, which analyzes biological indicators to guide treatment, is undeniably promising. Advances in precision medicine, like targeted therapies for pancreatic cancer, show real potential. Yet, mandating coverage for every test deemed 'evidence-based' ignores a harsh reality: not every patient needs or benefits from these costly diagnostics. The average test costs insurers $224, but out-of-pocket expenses can soar past $10,000 without coverage. Forcing insurers to foot the bill will inevitably drive up premiums, hitting working families hardest. New Jerseyans already grapple with rising healthcare costs, and this law adds fuel to that fire.

The narrative pushed by the bill’s advocates is seductive: who wouldn’t want access to cutting-edge care? But the idea that government mandates are the only path to progress is flawed. It assumes families can’t make informed choices about their healthcare and that insurers, left unchecked, will deny necessary tests. This distrust in markets and individuals underpins the law, reflecting a broader pattern of overreach that dismisses personal responsibility and competition as tools for better care.

At its core, this mandate represents a choice: prioritize access to advanced diagnostics for some or preserve affordability and flexibility for all. New Jersey’s leaders have chosen the former, betting that voters will overlook the long-term costs. They’re wrong. Families deserve policies that empower them, not ones that saddle them with bills they didn’t choose.

Healthcare costs in the U.S. are spiraling, and New Jersey’s new law won’t help. As of early 2025, 35% of Americans, roughly 91 million people, say they can’t afford quality care. In New Jersey, where median household incomes hover around $85,000, families already stretch to cover premiums and deductibles. Adding mandatory coverage for biomarker testing, even if targeted at serious conditions like cancer or Alzheimer’s, risks pushing more households into financial strain. The law’s backers argue it will lower long-term costs by enabling precise treatments, but evidence for widespread savings is thin. Precision medicine is advancing, but its benefits are often overstated, especially for conditions with complex, multifactorial causes.

Historical trends back this up. Since the Affordable Care Act’s mandates took effect, premiums have climbed steadily, with medical cost trends projected to rise 7.5–8% in 2025. States like California and Massachusetts, which have piled on similar coverage requirements, haven’t seen the promised cost reductions. Instead, their residents face some of the nation’s highest insurance rates. New Jersey’s law, while narrower, follows the same playbook: mandate first, figure out the fallout later. Forcing insurers to cover tests tied to FDA approvals or Medicare determinations sounds reasonable, but it opens the door to ever-expanding requirements as new tests emerge, each adding to the cost burden.

Advocates like Gopal and Sumter frame the law as a moral imperative, citing stories of cancer survivors who credit biomarker testing for their recovery. These are powerful anecdotes, but they don’t justify blanket mandates. Not every patient with a serious illness needs or benefits from these tests, and many effective treatments don’t require them. By prioritizing access to biomarker testing over affordability, the law risks sidelining families who need basic care but can’t afford rising premiums. It’s a classic case of good intentions paving a costly road.

There’s a smarter way to expand access to biomarker testing without heavy-handed mandates. Markets, when freed from excessive regulation, can deliver innovative care at lower costs. Health savings accounts, high-deductible plans, and transparent pricing empower families to choose the diagnostics and treatments that suit their needs. If biomarker testing is as life-changing as its supporters claim, insurers will compete to offer it, driven by consumer demand and the promise of better outcomes. Forcing coverage through legislation short-circuits this process, stifling competition and innovation.

Conservative policy proposals have long emphasized this approach. Leaders like Senators Rand Paul and Mike Lee have pushed for deregulating insurance markets, arguing that competition drives down costs and improves quality. In states like Texas and Indiana, which have embraced market-oriented reforms alongside targeted mandates, healthcare costs are more manageable than in heavily regulated states like New Jersey. By contrast, New Jersey’s law leans on government to dictate terms, assuming bureaucrats know better than families or providers what care is worth covering.

The law’s supporters argue that markets alone can’t ensure equitable access, pointing to disparities in care for Black and Hispanic patients. But mandates aren’t a silver bullet for equity. The ACA’s expansions reduced the uninsured rate to under 8%, yet 46% of Black adults and 52% of Hispanic adults still report affordability issues. Throwing more mandates into the mix won’t close these gaps; it will likely widen them by driving up costs for everyone. Targeted subsidies for low-income patients or incentives for insurers to cover high-value tests would do more to address disparities without punishing the middle class.

New Jersey’s biomarker testing law is part of a broader trend of states piling on insurance mandates. Since the ACA’s federal mandate was gutted in 2019, states like California, Rhode Island, and New Jersey have stepped in with their own requirements, from mental health coverage to advanced diagnostics. Each sounds noble in isolation, but together, they create a patchwork of rules that drive up costs and confuse consumers. New Jersey’s law, for instance, applies only to state-regulated plans, leaving those with self-insured employer plans unaffected. This inconsistency fuels frustration and undermines trust in the system.

The law also sets a dangerous precedent. By tying coverage to vague criteria like 'medical and scientific evidence,' it invites endless expansion. What’s to stop lawmakers from mandating coverage for the next big thing in healthcare, whether it’s AI-driven diagnostics or experimental gene therapies? Each new requirement chips away at the ability of families to choose plans that fit their budgets and priorities. Over time, this erodes the very freedom that makes America’s healthcare system, for all its flaws, a beacon of innovation.

Skeptics of this view might argue that mandates like New Jersey’s are necessary to keep pace with medical advances. But innovation doesn’t need government strong-arming to thrive. The rapid growth of targeted therapies since 2014, with over 25% of FDA-approved drugs now classified as personalized medicines, happened despite regulatory hurdles, not because of them. Private investment, not state mandates, has fueled breakthroughs in single-cell sequencing and spatial transcriptomics. New Jersey’s leaders should trust markets to deliver these advances, not burden families with rules that make healthcare less affordable.

New Jersey’s biomarker testing mandate is a classic example of policy that sounds good on paper but falters in practice. It promises cutting-edge care while ignoring the reality of rising costs and shrinking choices. Families don’t need more government rules dictating what their insurance must cover; they need affordable plans that let them decide what’s best for their health. Lawmakers like Gopal, Singleton, and Sumter may believe they’re saving lives, but their approach risks pricing families out of the care they need most.

The path forward is clear. New Jersey should roll back this mandate and others like it, replacing them with policies that unleash competition, reward innovation, and respect individual choice. Health savings accounts, price transparency, and targeted subsidies can expand access to biomarker testing without forcing every family to pay for it. By trusting markets and empowering consumers, the state can deliver better care at lower costs, proving that freedom, not mandates, is the key to a healthier future.