JAMA publication by TRANSPERS Collaborators Addresses Rapid Emergence of State Biomarker Testing Insurance Coverage Laws

In the JAMA article, The State of State Biomarker Testing Insurance Coverage Laws, by Lin et. al., the authors tackle the complicated topic of states legislating access to medical care. In response to perceived barriers to access to care, states have enacted legislation to mandate terms and conditions of insurance coverage for a variety of circumstances, such as cancer screening and mental health treatment parity. Recently there have been increasing numbers of states that have passed legislation mandating that insurers cover “biomarker testing”.

This review of legislation from 15 states mandating coverage of biomarker testing finds that their impact may be limited by their lack of reach and implementation challenges. While these laws attempt to expand access to coverage, that may not always be the case, since more than 50% of the population may not be covered by legislative mandates governing insurance coverage. Additionally, such insurance mandates may not affect inequities in access. Finally, there is little guidance for implementation in the legislation. The authors conclude that current laws are likely to have limited effect, particularly concerning improving health equity, and additional approaches will likely be needed to improve patient access and outcomes.

This study was led by Grace Lin, MD, MAS (UCSF School of Medicine) and TRANSPERS (UCSF Center for Translational and Policy Research) founding director Kathryn A. Phillips, PhD, with Janet Coffman, PhD, MPP, MA (UCSF Institute for Health Policy Studies). TRANSPERS is in the Department of Clinical Pharmacy at UCSF and is affiliated with the Philip R. Lee Institute for Health Policy Studies.