New law requires coverage for experimental cancer treatments

The Associated Press
Friday August 10, 2001

LOS ANGELES — Insurance companies will be required to provide basic medical coverage for cancer patients undergoing experimental treatments under a bill Gov. Gray Davis signed into law Thursday. 

Under the law, which Davis touted as the toughest in the nation, insurance providers must cover the costs of drugs, doctor visits, lab tests, hospitalizations and other routine services received by cancer patients involved in clinical trials. 

“It’s a historical agreement for the cutting edge of cancer treatment,” said Davis, who was joined by cancer survivors and officials outside a University of California, Los Angeles, medical lab where he signed the bill.  

“It gives cancer patients literally a new lease on life.” 

He said he hoped the new law, sponsored by Sen. Jackie Speier, D-Hillsborough, will encourage more cancer patients to enroll in clinical trials and therefore spur medical research that will lead to more advanced treatment of the disease. 



Until now, Davis said, insurance payouts for cancer patients undergoing experimental treatments have been a hit-or-miss prospect, as insurance providers struggled to define exactly which medical procedures were considered “routine” and eligible for coverage. 

“All they need for coverage (now) is for their physician to determine that the trial will have a beneficial effect on the patient,” Davis said. 

Expanding coverage will mean a “modest cost” for California’s managed care industry, or about less than 1 percent of the state’s annual premium of about $25 billion, said Walter Zelman, president of the California Association of Health Plans, a health insurance trade association. 

The new law will add about 3,390 Californians to clinical studies that would not have participated before, according to the American Cancer Society. 

Only 3 percent of adult cancer patients in the nation are currently enrolled in clinical trials, and clinical trial legislation in other states place restrictions on the type of procedure or test eligible for coverage, Davis said. 

“No other state in America even comes close,” he said of California’s new law. 

Davis and Zelman agreed that the bill was built on consensus between the state and health insurance industry. 

“It was not achieved by legislators and the governor pounding on a table then saying, ‘Do it my way,”’ Zelman said. “Instead, it was achieved by legislators and the governor pounding on the table, getting us together to make this work.” 

Davis vetoed a similar bill last year, which only required coverage for prostate cancer patients over half of the clinical trial.