NY bill would require health insurance coverage for cancer biomarker testing

Health insurance - Cancer biomarker test

Lawmakers and cancer survivors came together in support of the New York legislation.

Last week, New York lawmakers and cancer survivors gathered by the hundreds in Albany in support of legislation that would require health insurance companies to cover patient testing for cancer biomarkers.

Insurers, however, have expressed their opposition to the bill for this new coverage requirement.

Cancer Action Day at the New York state Capitol was focused on the mandate which would apply to Medicaid all health insurance policies providing major medical coverage. They would all be required to cover cancer biomarker testing for the diagnosis, treatment or management of the disease.

Health insurance - Cancer Treatment

“We’re talking about the future of cancer care,” said American Cancer Society Cancer Action Network Senior Government Relations Director Michael Davoli. “What science has showed us is precision medicine is the future, but to unlock precision medicine, we need to improve access to biomarker testing.”

The health insurance coverage would pay for testing offering patients a wealth of medical information.

Biomarkers are what indicate an individual patient’s pathogens, biological processes, and even the way they would respond to certain treatments. Beyond that, they provide identification of genetic mutations that could affect the most effective treatment. All patients with a cancer diagnosis have their own unique version of the disease, which means that there is no cookie-cutter treatment that provides the same benefit for every patient.

American Cancer Society advocates have stated that the organization will make certain that all New York cancer patients have access to precision medicine or the best available treatment for them.

“Unfortunately, there are millions of New Yorkers who don’t have access to biomarker testing because their health insurance plans don’t cover it,” explained Davoli.

Advocates have argued that by covering the testing, it would eliminate the trend toward excessive testing and treatment. As a result, over time, it would end up saving the health insurance companies money instead of costing them more because of the test.

Health Practitioner Association President and CEO Eric Linzer cautioned that the bill’s wording establishes overly broad criteria for the requirement for biomarker tests, which might not end up aligning with best medical practices.

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