The Association for Clinical Oncology (ASCO) is actively engaged in advocacy to protect Medicaid access for millions of Americans. Members can support ASCO’s Medicaid advocacy efforts through the ACT Network. In 2025, ASCO has partnered with other health-care organizations and engaged with lawmakers at the federal and state levels. Here are some highlights of these efforts by the Association.
Writing to Congressional Leaders About Potential Medicaid Cuts
On May 13, ASCO, along with several dozen medical organizations representing physicians across specialties, urged Congressional leaders to oppose proposed changes to Medicaid that would alter its federal financing structure, limit eligibility, shift costs to states, and increase administrative complexity. The organizations noted that these changes would threaten patient access to essential medical and surgical care, including preventive services and chronic disease management for more than 80 million Americans, potentially leading to coverage loss and exacerbating hospital and practice closures, especially in rural areas. They emphasized that Medicaid is a critical component of the health-care system, improving health outcomes and saving lives, and urged Congress to maintain coverage while offering to collaborate on sustainable strategies to strengthen the program.
On May 6, ASCO and other organizations in the Cancer Leadership Council (CLC) issued a statement emphasizing the critical role of Medicaid for more than two million patients with cancer, including one in three newly diagnosed children. The letter expressed concerns over proposed spending cuts, highlighting that Medicaid provides essential access to the full spectrum of cancer care, from screening to survivorship. The CLC argued that these cuts will directly harm patients with cancer, potentially ending their benefits and hindering the nation’s progress against cancer, urging the committee to reject such measures.
In an April 29 letter, ASCO wrote to members of the House Committee on Energy and Commerce urging Congress to safeguard Medicaid for patients with cancer by opposing legislation to reduce federal support, restrict access, or create barriers.
In an April 4 letter, ASCO warned lawmakers against making changes to the federal medical assistance percentage, which would place a financial burden on states and potentially result in millions losing coverage. The letter also opposed work requirements that would disproportionately impact patients undergoing treatment. In addition, the Association urged Congress to provide a clear exemption from work requirements for patients in active treatment and for at least 1-year after treatment, citing research that shows disruptions in coverage lead to worse survival rates and advanced-stage disease.
Joining Forces With the Alliance for Childhood Cancer
On May 12, the Alliance for Childhood Cancer, which includes ASCO and 16 other organizations, wrote to Congressional leaders to express their strong concern regarding proposed Medicaid spending cuts being considered by the House Energy & Commerce Committee.
The organizations deeply opposed the proposed cuts, which could amount to at least $625 billion, arguing that these changes would limit access to care, create administrative burdens like work requirements that are especially challenging for patients with cancer and their families, and threaten the financial stability of children’s hospitals. They highlighted that parental coverage is linked to children’s coverage and that work requirements have historically led to significant coverage losses. They urged Congress to reject these cuts to protect children with cancer and ensure their access to quality, uninterrupted health care.
In March, the Alliance sent a joint letter to key leaders in the House and Senate, urging them to protect Medicaid and the Children’s Health Insurance Program. The letter highlighted the role these programs play in providing health care to more than 37 million children and 80 million individuals nationwide, particularly those facing childhood cancer.
The stakeholders also shared their concerns over proposed policy changes, including block grants, per capita caps, and cuts to federal medical assistance percentages. They also opposed any changes that would restrict eligibility, reduce benefits, or create administrative barriers that would disproportionately harm children with cancer and their families.
Engaging With Lawmakers at the State Level
ASCO continues to engage in state-level advocacy to protect Medicaid access for patients with cancer, focusing on two key areas: Medicaid work requirements and Medicaid expansion.
Medicaid Work Requirements: ASCO and state affiliates have advocated for exemptions for patients with cancer from Medicaid work requirements. The organization has taken the following actions:
- Arkansas and Ohio: The Association and the Ohio Hematology Oncology Society provided comments on state proposals for Section 1115 waivers, which seek to establish work requirements. ASCO recently submitted comments to the Center for Medicaid and CHIP Services on Ohio’s proposed waiver.
- Indiana, Iowa, and Missouri: The Indiana Oncology Society, Iowa Oncology Society, and Missouri Oncology Society submitted comments on state bills aimed at implementing work requirements. Of note, in Indiana, advocacy efforts resulted in the removal of a proposed enrollment cap from the bill. The Missouri Oncology Society addressed the potential impact of a work requirement ballot measure.
Medicaid Expansion: In collaboration with the Montana State Oncology Society, ASCO supported legislative efforts to extend Medicaid expansion, which was set to expire in June 2025 before the extension was ultimately signed into law. The bill signed into law included work requirement provisions for expansion enrollees, which ASCO expressed concerns about.
Potential Impacts of Medicaid Funding Changes
The potential for federal Medicaid funding cuts poses a significant threat to coverage in several states:
- Trigger Laws: Eight states—Arkansas, Illinois, Indiana, Montana, New Hampshire, North Carolina, Utah, and Virginia—have trigger laws that would terminate their Medicaid expansions if federal funding falls below 90%. A ninth state, Arizona, has a trigger law that goes into effect at 80%. These laws could result in nearly 3.7 million people losing coverage.
- State Mitigation Requirements: Three states—Iowa, Idaho, and New Mexico—have laws requiring them to mitigate the financial impact of reduced federal funding, which could lead to 600,000 individuals losing coverage.
Other ASCO Medicaid policy statements and efforts include the following:
- Policy Statement on Medicaid Reform (2014);
- Medicaid Waivers & Impact on Cancer Care (2018);
- Medicaid and Cancer Care Access (2022).
© American Society of Clinical Oncology. ASCO in Action. May 13, 2025. All rights reserved.
