New York Budget Proposal Threatens Biomarker Testing Coverage for Medicaid Patients

Health care advocates fear the state could be rolling back progress on access to life-saving cancer screenings.

Apr. 7, 2026 at 9:53pm

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A highly detailed, translucent X-ray-style image revealing the intricate internal structure of a human cell, conveying the complex biological processes that biomarker testing aims to analyze.Biomarker testing provides a critical window into the inner workings of the human body, guiding personalized cancer treatment plans.NYC Today

New York state is proposing changes to its Medicaid program that would require Medicaid enrollees to meet "medical necessity criteria" for coverage of biomarker testing, a critical tool in cancer diagnosis and treatment. Health care advocates warn this could reverse the progress made in 2023 when the state mandated insurance coverage for biomarker testing, arguing it would disproportionately impact low-income individuals and communities of color.

Why it matters

Biomarker testing is considered a game-changer in cancer care, allowing doctors to identify indicators that signal normal or abnormal biological processes and guide more personalized treatment plans. Advocates fear the proposed changes could limit access to this important diagnostic tool for Medicaid patients, potentially worsening health outcomes and disparities.

The details

In 2023, New York passed a law requiring insurance providers, including Medicaid, to cover biomarker testing. However, the state's current 2027 budget proposal states that all biomarker tests covered by Medicaid must now meet "required medical necessity criteria." Health care advocates argue this could effectively roll back the progress made just three years ago by restricting access to this critical cancer screening tool for Medicaid enrollees.

  • In 2023, New York state passed a law requiring insurance providers, including Medicaid, to cover biomarker testing.
  • The 2027 executive budget proposal from Gov. Kathy Hochul includes language that would require Medicaid enrollees to meet "medical necessity criteria" for biomarker test coverage.

The players

Kathy Hochul

The Governor of New York who signed the 2023 law expanding biomarker testing coverage, but is now proposing changes that could roll back that progress.

Lexy Mealing

A 52-year-old breast cancer survivor who credits biomarker testing as integral to her treatment and survival.

Michael Davoli

A representative from the American Cancer Society Cancer Action Network who argues the proposed changes would disproportionately impact low-income individuals and communities of color.

Jacqueline Nesbit

A Bronx resident and lung cancer survivor who says she has "watched for too long as people of color, low-income individuals, and neighbors" have been "shut out of advances like biomarker testing."

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What they’re saying

“It was life-shattering.”

— Lexy Mealing, Breast cancer survivor

“[The biomarker testing] helped my physicians have a clear, open path to the treatment plan that was best for me.”

— Lexy Mealing, Breast cancer survivor

“There are diseases out there where there is no cure right now, like ALS. But one day, there will be a cure, and it will come because of biomarker testing.”

— Michael Davoli, American Cancer Society Cancer Action Network

“I've watched for too long as people of color, low-income individuals, and neighbors of mine disproportionately shoulder the burden of disease like cancer. It's largely because we've been shut out of advances like biomarker testing.”

— Jacqueline Nesbit, Bronx resident and lung cancer survivor

“We should not be balancing the state budget on the backs of cancer patients.”

— Michael Davoli, American Cancer Society Cancer Action Network

What’s next

Cancer survivors and advocates plan to continue urging state lawmakers to reject the governor's proposal to roll back Medicaid coverage of biomarker testing.

The takeaway

This proposal threatens to undermine the progress New York has made in expanding access to life-saving cancer screenings, disproportionately impacting low-income individuals and communities of color who already face significant health disparities. Advocates are calling on the state to protect and build upon the 2023 law mandating biomarker test coverage for Medicaid patients.