Maine first: Insurance must cover PFAS blood tests, revealing hidden health toll

• Maine will require health insurance plans to cover medically necessary PFAS blood tests starting January 1, 2027, with costs ranging from $300 to $600 per test.
• The law targets high-exposure groups including firefighters, military veterans, factory workers and agricultural workers affected by PFAS-contaminated sludge.
• PFAS, or “forever chemicals,” are linked to cancer, liver damage, thyroid disease, high cholesterol and developmental delays in children.
• The National Academies of Sciences, Engineering and Medicine recommends blood tests for those with known PFAS exposure to monitor potential health effects.
• Maine previously became the first state to ban PFAS in consumer products (2021) and ban contaminated sludge on farmland (2022).

Starting January 1, 2027, Maine will require health insurance companies to cover medically necessary blood tests for PFAS, the synthetic “forever chemicals” linked to cancer, liver damage and immune system harm. The law, signed by Gov. Janet Mills this year, addresses what health experts describe as a silent contamination crisis affecting nearly every American. About 200 million people across the United States may have PFAS in their drinking water at levels exceeding 1 part per trillion, according to peer-reviewed research published in Environmental Science & Technology Letters. The Maine measure—passed as LD 582 by Sen. Stacy Brenner, D-Scarborough—aims to remove financial barriers to screening, with tests costing $300 to $600. The law applies to all health plans operating in Maine.

Why blood testing matters now

PFAS, or per- and polyfluoroalkyl substances, have been used since the 1940s in non-stick cookware, waterproof clothing, food packaging, firefighting foam and countless other products. They persist indefinitely in the environment and accumulate in human tissues. The Centers for Disease Control and Prevention surveys show most Americans carry some PFAS in their blood.

Blood tests can reveal individual exposure levels, but until now, cost has been a barrier. The Maine law mandates coverage for tests deemed medically necessary, particularly for people whose occupations or locations put them at higher risk.

The National Academies of Sciences, Engineering and Medicine recommends blood tests for people with known PFAS exposure, including:

• Firefighters and military veterans
• Factory workers in PFAS-related industries
• Agricultural workers exposed to contaminated biosolids
• Residents near Superfund sites or military installations

Health evidence mounts

Peer-reviewed studies link PFAS exposure to elevated cholesterol, thyroid dysfunction, decreased vaccine response and increased risks of prostate, kidney and testicular cancers. Research shows reproductive harms, including decreased fertility and high blood pressure in pregnant women. Children face developmental risks, including low birth weight and accelerated puberty.

A study published by Toxic-Free Future, Indiana University and the University of Washington found PFAS in all 50 breast milk samples tested, at levels nearly 2,000 times higher than the safe drinking water limit of 1 part per trillion. PFAS concentrations in breast milk ranged from 50 to over 1,850 parts per trillion, with levels doubling globally every four years.

The Environmental Protection Agency’s current lifetime health advisory level—70 parts per trillion for two specific PFAS compounds—is considered inadequate by independent scientists. The EPA has identified over 600 PFAS in active use in the United States. Contamination has been found at more than 2,230 locations across 49 states, including over 300 military installations.

Maine’s pioneering role

Maine has developed some of the nation’s strictest PFAS regulations. In 2021, it became the first state to ban PFAS in most consumer products. In 2022, it banned application of PFAS-contaminated wastewater sludge on agricultural land—a practice that exposed farming communities after decades of using sludge as fertilizer.

The blood test law represents a step beyond prevention toward medical monitoring. By requiring insurance coverage, Maine aims to collect data on exposure patterns while giving patients and doctors tools for early intervention.

Federal inaction, state action

At the federal level, the PFAS Action Act passed by the House would set a two-year deadline for a national drinking water standard and designate PFAS as hazardous substances under Superfund law. But the Senate has not acted. The EPA continues accepting public comment on PFAS regulations, with a virtual hearing scheduled.

Meanwhile, states including California, Massachusetts, Michigan, New Hampshire, New York, Vermont and New Jersey have set their own limits on PFOA and PFOS. New Jersey was first with a maximum contaminant limit of 13 parts per trillion for PFNA and standards of 13 ppt for PFOS and 14 ppt for PFOA. The European Union has initiated a broader ban.

Looking forward: Prevention as the ultimate goal

Blood tests cannot remove PFAS from the body. They can only reveal contamination already present. The medical community emphasizes that reducing exposure—through bans on non-essential PFAS uses, drinking water standards and cleanup of legacy pollution—remains the primary goal.

Dr. Rachel Criswell, a family physician and environmental researcher at Redington-Fairview Hospital in Skowhegan, treats patients including firefighters, veterans and factory workers with elevated PFAS levels. When results show high concentrations, doctors recommend increased screenings for adults and children.

The Maine law offers a model for other states. By requiring insurers to cover testing, it acknowledges that measuring contamination is a necessary first step—but not a solution. As the EPA notes, PFAS do not degrade. They build up in soil, water and blood. The question now is whether other states will follow Maine’s path from awareness toward accountability.

Sources for this article include:

ChildrensHealthDefense.org

MaineSenate.org

EPA.gov