ASCO's Legislative Advocacy for Medicaid and Health Care in 2026

In 2026, forty-six states and Washington, D.C., embarked on legislative sessions facing significant budget strains under the newly implemented H.R. 1. The Association for Clinical Oncology (ASCO) partnered with State Affiliates and coalition groups to champion advocacy priorities, tracking over 630 legislative bills and numerous regulations. The group issued more than 180 letters to state policymakers to steer these changes.

Focusing on Medicaid and high-quality care, ASCO prioritized safeguarding Medicaid access amid states implementing work requirements tied to Medicaid expansion under H.R. 1. Collaborating with State Affiliates, they challenged legislation and regulatory adherence imposing such requirements. They engaged proactively with state Medicaid directors before the Centers for Medicare & Medicaid Services issued an interim rule, while also providing feedback on exempt medical codes.

ASCO opposed legislative efforts in Ohio, New Hampshire, and Wisconsin that sought to create health plans bypassing the ACA's essential benefits. Conversely, they supported proposed transparency measures for non-ACA compliant plans in Florida and Utah. Although both proposals passed one legislative chamber, they failed in the second.

In fertility preservation strides, ASCO, together with the Alliance for Fertility Preservation, successfully backed laws in Hawaii and Virginia to extend access for cancer patients. Additionally, nearly 150 bills across 43 states tackled utilization management reform, particularly focusing on AI-driven prior authorization delays. ASCO supported new laws in several states, maintaining efforts against co-pay accumulator programs.

ASCO also influenced significant legislation with the State Access to Innovative Medicines Coalition, advocating for step therapy and pharmacy benefit manager reforms in multiple states. Indiana and Tennessee passed laws prohibiting step therapy for metastatic cancer treatments.

In Virginia, ASCO endorsed policy requiring insurers to offer at least one plan with capped monthly drug expenses and mandating pharmacy benefit managers to channel complete rebates to patients. Preparing for the 2027 legislative agenda, ASCO strategizes with State Affiliates amid upcoming elections.

ASCO plans to attend the National Conference of State Legislatures Legislative Summit in Chicago, highlighting Medicaid access for cancer patients. For comprehensive legislative resources, stakeholders are directed to ASCO’s State Advocacy site, which provides a bill tracker and legislative calendar. For advocacy inquiries, contact ASCO’s representatives, Sarah Lanford, Nick Telesco, or Rachel Jordan.