July 8th, 2020- Illinois Medicaid recipients are now eligible for life-saving clinical trials to treat cancer and other serious diseases.
Governor Pritzker enacted Senate Bill 1864, a health care package that includes a proposal by Senator Andy Manar requiring the state’s Medicaid program to cover routine care costs incurred for an approved clinical trial involving the prevention, detection, or treatment of cancer or any other life-threatening disease, as long as Medicaid would normally cover those same routine care costs for a non-clinical procedure.
“It’s not an exaggeration to say that this law will save lives. For too long, some people were granted access to the most advanced and potentially life-saving cancer treatment, and others weren’t, simply depending on which insurance plan they had. That injustice ended today,” Manar said. “I appreciate Governor Pritzker’s demonstrated commitment to advancing equity in health care.”
Initially introduced and carried through the Senate by Manar, the initiative was included in a broader health care package passed by the General Assembly during the abbreviated special session in May.
More than 20% of Illinoisans are covered by Medicaid, making it the second-largest type of insurance behind Medicare.
Medicare and private insurance carriers are already required to provide coverage for routine care costs in clinical trial participation. Medicaid is not. This legislation would align Medicaid coverage for clinical trials with coverage under those insurance plans.
Because routine costs would be paid for by Medicaid if the patient were not on a clinical trial, there is a minimal cost difference for Medicaid to cover these costs within a clinical trial.
Manar worked closely with the American Cancer Society to draft the proposal.
“The state has taken an important step to ensure the viability of new cancer research in our state and to allow an additional 20% of Illinois residents to have access to the latest treatments and therapies,” said Shana Crews, Government Relations Director at the American Cancer Society Cancer Action Network. “We look forward to working with state leaders to further reduce Illinois’ cancer burden.”