Organizations Demand Clinical Trial Coverage for Medicaid Patients

A broad coalition is calling for Congress to ensure Medicaid patients receive access to potentially life-saving clinical trials, according to a recent letter to Congressional leaders.

Last week, 106 organizations representing patients, medical researchers, survivors, and families urged Congress to include the bipartisan Clinical Treatment Act (HR 913) in the healthcare extenders package. If added and passed, this would guarantee coverage for the costs associated with clinical trial participation among Medicaid enrollees with life-threatening conditions. 

“Clinical trials often provide patients with the best, and perhaps only, treatment option for their disease,” Monica Bertagnolli, MD, FACS, FASCO, chair of the Association for Clinical Oncology, and affiliated professional organizer of the American Society of Clinical Oncology said in a recent press release.

The Association for Clinical Oncology, the American Medical Association, the American Heart Association, and the American Cancer Society Cancer Action Network are a few of the organizations backing the bill. 

Routine costs such as physician visits and laboratory tests are considered a part of standard care and are necessary for all patients, regardless of clinical trial participation.  Due to this standard care, the adoption of the act would have little to no impact on the Medicaid budget, making it a strong candidate for inclusion.  

Currently, about 20 percent of Americans receive their health insurance coverage through Medicaid, which is not federally required to cover routine care costs for clinical trials, the letter stated. Therefore, many Medicaid beneficiaries with life-threatening conditions do not have access to the latest scientific treatments.

Specifically, there are nearly 42.2 million Medicaid patients that may be without this needed coverage. 

Clinical trial participation greatly improves the quality of medical research by representing those Medicaid beneficiaries in vulnerable areas who were not previously well-represented in clinical trials, the letter highlighted. 

The Clinical Treatment Act could help to improve the validity of clinical research data and deliver better cures to all patients. Covering routine costs of clinical trials for Medicaid beneficiaries will ensure all patients have access to high-quality care. 

“Increased access to clinical trial participation for Medicaid enrollees helps ensure medical research results more accurately capture and reflect the population of this country,” the letter emphasized. 

The healthcare extenders package is expected to pass this spring before the current funding expires on May 22. 

“This is a simple fix, and one that should be addressed by Congress as soon as possible,” the letter declared.