Sponsors
The bill broadly expands no-cost Lp(a) and apoB testing across payers to improve early detection and prevention of cardiovascular events, while increasing public and private health‑care spending and adding administrative burdens that could raise premiums or leave some follow-up care with out‑of‑pocket costs.
People at risk for cardiovascular disease — including those with private group/individual coverage, Medicare beneficiaries, and Medicaid enrollees — will gain Lp(a) and apolipoprotein B testing covered with no cost-sharing, expanding access to preventive screening.
Earlier identification of elevated Lp(a) or apoB for people with family history or other risk factors could enable targeted prevention and treatment, potentially reducing future heart attacks and strokes.
Heart attack survivors and others at high risk could receive more effective follow-up care and risk management if these findings prompt guideline updates and changes in clinical practice.
Expanding mandated coverage increases federal and private health-care spending, which could translate into higher insurance premiums, larger federal/state budgets, or greater taxpayer costs.
Some patients may still face additional out-of-pocket costs for follow-up interventions or treatments triggered by test results if those services are not similarly required to be covered.
Clinics, laboratories, insurers, and other providers may face higher administrative, testing, and implementation costs and workload if screening and new protocols are widely adopted.
Based on analysis of 3 sections of legislative text.
Requires private plans, Medicare, and Medicaid to cover and prohibit cost-sharing for Lp(a) and ApoB testing for people with specified cardiovascular risk factors.
Introduced April 14, 2026 by Sheila Cherfilus-McCormick · Last progress April 14, 2026
Requires private group and individual health plans, Medicare, and Medicaid to cover tests for lipoprotein(a) (Lp(a)) and apolipoprotein B (ApoB) without patient cost-sharing for people with specified cardiovascular risk factors (family history of premature cardiovascular disease, prior heart attack or stroke, high LDL, diabetes, obesity, or other recognized risk factors). Coverage rules apply starting for plan years that begin 180 days after the law is enacted, with Medicare and Medicaid covering items and services furnished on or after that date.