Governor Hochul Signs 3 New Health Care Laws: Here’s What’s Covered for New Yorkers
At a Glance:
- Three new laws aimed at health care affordability for New Yorkers took effect Jan. 1
- Tests for detecting breast cancer are covered
- EpiPen costs are capped
- Scalp cooling treatments for chemotherapy are covered
If you have ever been denied coverage by your health insurance company for a treatment, device or procedure you or a member of your family were medically in need of, then you have experienced true frustration.
Governor Kathy Hochul announced this week that with the new year comes three new laws aimed at making health care affordable for New Yorkers.
As of Jan. 1, 2026, insurance companies are now legally required to cover breast cancer screening and imaging, as well as scalp cooling systems for chemotherapy patients, and to cap the cost of medically necessary EpiPens at $100 per year.
“New Yorkers shouldn’t have to choose between putting food on the table or being able to afford life-saving medical devices and procedures,” Governor Hochul said. “With these new laws going into effect, individuals will be able to focus on their health and wellbeing without having to worry about the financial burdens tied to treatments.”
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Breast Cancer Screening and Imaging
In New York, at least 17,000 females are diagnosed with breast cancer each year and nearly 2,400 die from it, making it the second leading cause of death among females in the state.
Under the new law, insurance companies will be required to cover breast cancer screening and diagnostic imaging, including mammograms, ultrasounds and MRIs when recommended by a doctor. The law removes out-of-pocket costs for these procedures, unless doing so would violate IRS rules for HSA-eligible health plans, in which case cost-sharing is still allowed.
EpiPens
An EpiPen is required for anyone at risk of anaphylaxis, a life-threatening allergic reaction. Individuals in need of EpiPens are required to carry two at all times (in case one dose of epinephrine is not enough to counter the reaction). The devices expire after just 12 months, and can cost up to $600 for a pack of two, making it a costly measure of prevention. These same pens sold for just $60 each at one time, a drastic difference from the current pricetag.
The new law requires health insurers to cap out-of-pocket costs for EpiPens at $100 annually, regardless of the price of the pen. The law applies to individual and group markets, including non-profit insurers and HMOs.
Scalp Cooling Systems
A scalp cooling system is a device that cools the head during chemotherapy to help prevent hair loss. As part of the treatment, patients wear a cooling cap before, during and after each chemotherapy session to reduce the amount of drugs that reach the hair follicles, helping to preserve hair.
Without insurance, these devices can cost $1,500 to $3,000 per round of chemo. Under the new law, health care insurers in the large group market must cover the cost for chemotherapy patients. It is currently covered under Medicaid and Medicare.
“I introduced the scalp cooling bill year after year, and it really hit home for me personally in 2023 when my daughter-in-law, Kristen Zebrowski Stavisky, was diagnosed with breast cancer,” said State Senator Toby Ann Stavisky. “Preserving hair during chemotherapy treatment is essential and helps [people] hold onto a sense of identity and normalcy as a person, not a cancer patient.”
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