Policy Prescriptions: Three Concrete Proposals for Expanding Cancer Treatment Access in NYC
BioPolicy exists to move past just describing the access gap and toward proposing something specific to close it. Based on what the research actually shows — not just for cancer broadly, but for the exact places New York's system currently breaks down — here are three proposals worth building policy around.
1. Expand the Medicaid Cancer Treatment Program beyond four cancer types
New York's Medicaid Cancer Treatment Program currently covers uninsured, low-income patients (at or below 250% of the Federal Poverty Level) for exactly four cancers: breast, cervical, colorectal, and prostate. Every other cancer diagnosis falls outside this specific safety net. The infrastructure — eligibility screening, provider networks, the program itself — already exists and is already working for those four cancers. Expanding the covered diagnosis list doesn't require building something new; it requires widening a door that's already open. This is the single highest-leverage, lowest-friction proposal on this list, because it uses a program the state has already proven it can run.
2. Bring trial access — and the cost of participating — to the patient, not the other way around
Clinical trial enrollment is currently concentrated at academic medical centers, and enrollees skew heavily white and higher-income; researchers tie this directly to transportation, lost wages, and insurance barriers, not lack of interest or eligibility. A city-level policy could fund trial-associated travel and lost-wage reimbursement for low-income patients specifically, and incentivize partnerships between academic trial sponsors and community hospitals in underserved boroughs, so that "closest hospital" and "hospital running the trial" aren't two different, distant buildings.
3. Require plain-language, standardized cost disclosure before treatment begins
Right now, what a specific patient will actually owe for a specific treatment is often unknowable until after the fact — it depends on negotiated rates between insurers and providers that patients can't see in advance. A NYC-level requirement that hospitals disclose expected patient cost-share in plain language before a treatment plan is finalized wouldn't lower drug prices, but it would remove the specific failure point where families delay or skip treatment because they don't know what it will cost until the bill arrives. Delay has a direct cost: earlier Medicaid coverage is already associated with more patients starting treatment within 60 days of diagnosis and better survival — meaning speed to treatment isn't a convenience, it's an outcome.
Why these three
Each of these targets a specific, evidenced breakdown point — eligibility, physical/financial access to trials, and cost uncertainty — rather than trying to fix "healthcare access" as one enormous problem. They're also each achievable at the state or city level, without waiting on federal drug pricing reform that may or may not happen. That's the kind of proposal BioPolicy wants to keep making: specific enough to actually implement, and grounded in exactly where the New York system is currently failing the families it's supposed to serve.