Preserve Medicaid Patient Access To Biomarker Testing

Reject the proposal to roll back important Medicaid coverage for biomarker testing. 

Two years ago the state legislature passed, and Governor Hochul enacted, a historic law that enabled patients across the state to access critical biomarker testing.  Treatments based on biomarker testing can improve health outcomes, increase quality of life, reduce health disparities and lower overall health care spending.

The legislature passed this legislation with overwhelming, bipartisan support, ensuring more equitable access to proven biomarker testing, which is key to matching some patients with the most effective treatment for cancer and other diseases.  

Unfortunately, the governor’s budget proposes rolling back important Medicaid coverage for biomarker testing. The governor’s proposal would reverse this gain for health equity by jeopardizing coverage for millions of New Yorkers.  

Please join ACS CAN in calling on state lawmakers to preserve Medicaid patients’ access to biomarker testing.  

Background

Research shows that biomarker-informed treatments can improve health outcomes, increase quality of life, and prolong patient survival.^[i],[ii] Using the traditional trial and error method to identify an effective treatment for a particular patient can take months — even years. In chronic, degenerative diseases like rheumatoid arthritis, any length of time spent trying (and failing) on ineffective treatments allows the disease to continue causing irreversible damage to the joints, increasing health care consumption and costs.

In cancer care and some autoimmune conditions, the length of time it takes to identify an effective treatment can be a matter of life or death. In all cases, ineffective treatments exacerbate the physical, emotional, and economic burdens of disease, and the price is paid by both the patient and the insurer.

The governor’s proposal would reverse this gain for health equity by eliminating the established coverage criteria for Medicaid enrollees, while people with private insurance are not impacted. Consistent coverage criteria across Medicaid and private plans allow providers to understand what is covered and provide equitable treatment for patients across payors.

Without equitable coverage and access to biomarker testing, advances in precision medicine could exacerbate existing disparities in access to care and, consequently, health outcomes associated with race, ethnicity, income, and geography.

Despite the clear benefits of biomarker testing, many insurance plans do not cover evidence-based biomarker testing for all patients who need it.

This is a shortsighted effort to save money that hurts patients – and could potentially cost Medicaid more. As the state grapples with federal funding cuts, it is more important than ever to spend Medicaid dollars efficiently – and upfront spending on biomarker testing can allow patients to avoid costly treatments that will be unnecessary or ineffective.

Please join ACS CAN in calling on state lawmakers to preserve Medicaid patients’ access to biomarker testing.  

The following organizations strongly urge that the proposes changes to biomarker coverage are not included in the one-house and final budgets. (as of 1/30/26)

• AiArthritis: International Foundation for Autoimmune & Autoinflammatory Arthritis
• ALS Association
• American Association of Clinical Urologists (AACU)
• American Cancer Society Cancer Action Network
• American Clinical Laboratory Association
• American Lung Association
• American Society of Pharmacovigilance
• Arthritis Foundation
• Autoimmune Association
• Biomarker Collaborative
• Cactus Cancer Society
• Cancer Support Community
• Cancer Support Team
• CancerCare
• Cheeky Charity
• Coalition of State Rheumatology Organizations (CSRO)
• Colon Cancer Coalition
• Color of Gastrointestinal Illnesses
• Columbia University Herbert Irving Comprehensive Cancer Center
• Crohn's & Colitis Foundation
• Debbie's Dream Foundation: Curing Stomach Cancer
• EndPreeclampsia.org
• Exon 20 Group
• Fight Colorectal Cancer
• FORCE: Facing Our Risk of Cancer Empowered
• GI Cancers Alliance, Inc
• Global Coalition on Aging
• Global Colon Cancer Association
• Global Liver Institute
• GO2 for Lung Cancer
• Head and Neck Cancer Alliance
• HEAL Collaborative
• Honor the Gift
• ICAN, International Cancer Advocacy Network
• Infusion Access Foundation (IAF)
• KRAS Kickers
• Lung Cancer Research Foundation
• LUNGevity Foundation
• Lupus and Allied Diseases Association, Inc.
• Memorial Sloan Kettering Cancer Center
• MET Crusaders
• Mosaic Health
• National Ovarian Cancer Coalition
• New York State Clinical Laboratory Association
• NewYorkBIO
• NewYork-Presbyterian Queens
• Oncology Nursing Society
• One Cancer Place
• Ovarian Cancer Research Alliance
• Patient Empowerment Network
• Patients Rising
• PDL1 Amplifieds
• Roswell Park Comprehensive Cancer Center
• Sickle Cell & Thalassemia Patient Network
• Stupid Cancer
• The Michael J. Fox Foundation
• The Raymond Foundation, Inc
• Triage Cancer
• VHL Alliance
• ZERO Prostate Cancer