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Committee sends biomarker coverage study to the House; staff warn a fiscal appropriation may be needed
Summary
S154 directs DFR and AHS to analyze costs and implementation requirements for health‑insurance and Medicaid coverage of biomarker testing and to report by 01/15/2027; staff said DFR likely cannot pay for the actuarial work using bill‑back authority and may need an appropriation to complete the study.
Jen Carby of the Office of Legislative Counsel described S154 to the Appropriations Committee: the bill directs the Department of Financial Regulation (DFR) and the Agency of Human Services (AHS) to analyze the costs of requiring health‑insurance and Medicaid coverage for biomarker testing that is supported by medical and scientific evidence and to report to policy committees and the legislature.
Carby explained the bill requires DFR to estimate how much premiums would increase if private insurance were mandated to cover biomarker testing and asks AHS to report on Centers for Medicare and Medicaid Services approvals needed for Vermont Medicaid to cover such tests.
Committee staff told members DFR cannot use its usual bill‑back mechanism (charging regulated carriers) to pay for an actuarial study required by statute for a non‑regulatory study. As staff explained, "for something like this, they would actually need an appropriation because they can't just bill." Committee members said they wanted the study but chose not to vote on any appropriation during the session; the committee moved the bill favorably while noting the fiscal note and resource questions must be resolved.
Committee action: Members voted to report S154 favorably to the next stage; staff will provide a fiscal note and DFR/AHS will later report their findings by the statutory deadline.
