New Health Care Laws Enhance Coverage for New Yorkers

Three new health care laws aimed at improving affordability for New Yorkers took effect on January 1, 2026. These legislative changes require insurance companies to cover breast cancer screenings, cap out-of-pocket costs for EpiPens, and provide coverage for scalp cooling systems used during chemotherapy. Governor Kathy Hochul emphasized that these laws will alleviate financial burdens associated with crucial medical treatments.

Comprehensive Coverage for Breast Cancer

Breast cancer remains a significant health concern in New York, with over 17,000 women diagnosed annually and nearly 2,400 deaths reported each year, making it the second leading cause of death among females in the state. Under the new legislation, insurance providers are mandated to cover breast cancer screening and diagnostic imaging, including mammograms, ultrasounds, and MRIs, when deemed necessary by a healthcare professional. This law effectively eliminates out-of-pocket costs for these essential procedures, unless it conflicts with IRS regulations for HSA-eligible plans.

Affordability for EpiPens

The new law significantly impacts the affordability of EpiPens, which are essential for individuals at risk of anaphylaxis, a severe allergic reaction. Patients are typically advised to carry two EpiPens, as a single dose may not be sufficient in emergencies. Currently, the cost of a two-pack can reach up to $600, a sharp increase from the previous price of around $60 each. The legislation caps annual out-of-pocket expenses for EpiPens at $100, ensuring that individuals and families can access this life-saving medication without financial strain.

Support for Chemotherapy Patients

Scalp cooling systems, which help mitigate hair loss during chemotherapy, will also be covered under the new law. These devices work by cooling the scalp before, during, and after chemotherapy sessions, reducing the amount of chemotherapy drugs that reach hair follicles. Without insurance, the cost of these systems can range from $1,500 to $3,000 per treatment cycle. The legislation mandates that health insurers, particularly in the large group market, cover these costs, aligning with existing coverage under Medicaid and Medicare.

State Senator Toby Ann Stavisky, who championed the scalp cooling bill, highlighted the personal significance of this legislation. “Preserving hair during chemotherapy treatment is essential and helps individuals maintain a sense of identity and normalcy,” she stated, reflecting on her own experiences with family members affected by breast cancer.

These legislative updates represent a significant step toward enhancing health care access and financial protection for New Yorkers facing serious medical challenges. With the implementation of these laws, individuals can focus on their health and well-being, lessening the anxiety typically associated with medical expenses.