New York Reduces Financial Barriers to Lifesaving Cancer Care

ALBANY, NY –12.23.22--Earlier today, Governor Hochul signed two bills into law, both of which address gaps in New Yorkers’ access to affordable, lifesaving care for those facing a cancer diagnosis—or other chronic illness. The two new laws aim to limit out-of-pocket expenses associated with preventative cancer screenings and prescription drug treatments. The details are as follows: 

1. A2085-A / S906-B, now Chapter 739, requires that every state-regulated large-group health plan cover 100% of the cost of colorectal cancer screening beginning at age 45 and removes cost-sharing for individuals who require a follow-up colonoscopy after a positive stool-based test. This protection will build off the NYS Department of Financial Services (DFS) Insurance Circular Letter No. 4 (2022) that requires the same of all issuers and health plans issued in New York State. Such coverage would be updated as screening guidelines are updated by the American Cancer Society and the United States Preventive Services Task Force.

While the original bill, passed by both houses in the spring, would have expanded coverage for every New Yorker on a state regulated, commercial health plan, the Governor’s office insisted on limiting it only to New York’s roughly 2.3 million large group plan enrollees. The remaining 17.5 million New Yorkers will be reliant on the above mentioned DFS regulation and rules stemming from the Affordable Care Act (ACA) to ensure their coverage.  Additionally, this leaves approximately 170,000 participants of short-term duration, non-ACA compliant plans excluded therefore leaving these New Yorkers without such coverage.

2. A1741/S5299, now Chapter 736, will help patients afford their prescription drugs by ending copay accumulator adjustment practices—a tactic employed by health plans to prevent patients from reaching their deductible or out-of-pocket maximum sooner. Many patients rely on financial assistance programs to reduce the cost of their medication, but insurers increasingly use a copay accumulator adjustment to undermine patients’ copay and financial assistance programs. This important legislation ensures that patients in New York will not be punished for using copay assistance and help New Yorkers afford lifesaving medication.

“With Governor Hochul’s signature, state leaders have taken significant steps in ensuring that every New Yorker has access to affordable, lifesaving care. We can expect to reduce colorectal cancer incidence and mortality rates as well as the financial burden of a cancer diagnosis,” said Michael Davoli, New York Government Relations Director for the American Cancer Society Cancer Action Network (ACS CAN). “Together these two laws represent an important step toward dismantling disparities and improving health outcomes for all New York residents. ACS CAN thanks Governor Hochul for signing these bills into law. Senators Rivera, Sanders, and Kennedy as well as Assemblymembers Gottfried and Dinowitz deserve high praise for their steadfast support for patient protections. Seeing our legislative leaders prioritize New Yorkers’ access to critical care is the perfect way to round out the year.”

###

About ACS CAN

The American Cancer Society Cancer Action Network (ACS CAN) makes cancer a top priority for policymakers at every level of government. ACS CAN empowers volunteers across the country to make their voices heard to influence evidence-based public policy change that improves the lives of people with cancer and their families. We believe everyone should have a fair and just opportunity to prevent, find, treat, and survive cancer. Since 2001, as the American Cancer Society’s nonprofit, nonpartisan advocacy affiliate, ACS CAN has successfully advocated for billions of dollars in cancer research funding, expanded access to quality affordable health care, and advanced proven tobacco control measures. We’re more determined than ever to stand together with our volunteers to end cancer as we know it, for everyone. Join the fight by visiting www.fightcancer.org.