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Bill

HB 8

Require health plan and Medicaid coverage of biomarker testing

136th Legislature (2025-2026) Introduced by Andrea White

Ohio bill mandates health insurance and Medicaid coverage of biomarker testing without prior authorization, expanding access to precision medicine diagnostics but increasing healthcare costs.

Referred to committee
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Bill Summary · HB 8

Legislative bill overview

HB 8 mandates that health insurance plans and Ohio's Medicaid program cover biomarker testing without prior authorization requirements. Biomarker testing identifies genetic, protein, or molecular characteristics that can guide personalized medical treatment decisions, particularly for cancer diagnosis and treatment selection.

Why is this important

Biomarker testing can improve patient outcomes by enabling targeted therapies and avoiding ineffective treatments, but high out-of-pocket costs or coverage denials often delay or prevent access. Removing coverage barriers could democratize access to precision medicine across income levels, though it may increase overall healthcare spending.

Potential points of contention

  • Cost implications: Expanding mandatory coverage increases insurance premiums and state Medicaid spending; fiscal impact depends on testing frequency and pricing
  • Medical necessity standards: Eliminating prior authorization removes quality control mechanisms insurers use to prevent inappropriate or duplicate testing
  • Scope ambiguity: The bill's definition of which tests qualify as "biomarker testing" remains unclear from the introduction, potentially creating implementation disputes
  • Clinical evidence: Disagreement exists over which biomarker tests have sufficient evidence to warrant universal coverage versus patient-specific indications

Compiled from official sources — confirm details with the bill’s official record.

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