New York Reduces Financial Barriers to Lifesaving Cancer Care
Governor Hochul approves two bills addressing gaps in New Yorkers’ access to affordable care
ALBANY, NY – DECEMBER 26, 2022 –Last week, 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 that of a 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:
- A2085-A / S906-B 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. Any updates to screening guidelines by the American Cancer Society or U.S. Preventative Services Task Force would be reflected in this new law, securing coverage for all recommended groups. 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 coverage to New York’s roughly 2.3 million large-group plan enrollees. The remaining 17.5 million New Yorkers will be reliant on the DFS regulation, mentioned above, and rules stemming from the Affordable Care Act (ACA) to ensure their coverage. The amendment championed by Governor Hochul will result in approximately 170,000 participants of short-term duration, non-ACA compliant plans being excluded from coverage.
- A1741/S5299 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 a huge 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.”
ACS CAN thanks every legislator, state leader and stakeholder who championed these issues. ACS CAN looks forward to the impact these new laws will have on cancer prevention and care delivery in New York.
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.