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Senate orders third reading of bill to require insurer coverage for certain biomarker tests; agencies will analyze cost
Summary
Senator Cummings described S154, a bill to require health insurance coverage for biomarker testing (including emerging Alzheimer's tests); the Health and Welfare committee recommended further actuarial analysis by AHS and DFR and the Senate ordered third reading.
Senator Cummings, reporting for the Committee on Health and Welfare, said S154 would require health insurance coverage for certain biomarker tests used to indicate disease predisposition or presence, including some recent tests tied to Alzheimer's disease treatments. She described both the clinical value—faster, more targeted care—and fiscal concerns: incorporating these tests into the state's insurance requirements could raise costs on the individual market and Medicaid because the federal exchange does not currently include many such tests.
"When it comes to cancer, you could be on chemotherapy and three months later it hasn't had any effect," Cummings said, noting biomarker tests can avoid unnecessary treatments by identifying likely benefit. The committee asked the Agency of Human Services and the Department of Financial Regulation to produce cost estimates and an actuarial analysis for consideration before further action.
Appropriations and Joint Fiscal Office outreach was reported; Appropriations' vote on the bill was recorded as 6‑0‑1. The Senate agreed to the committee's recommendation and ordered third reading.
Next steps: agencies (AHS and DFR) will provide cost estimates and an actuarial analysis to inform further action on coverage and Medicaid inclusion.
