HR6130

The ASAP Act (HR6130), introduced November 19, 2025 by Rep. Buchanan (R-FL) with 82 cosponsors, amends the Social Security Act to mandate Medicare coverage for blood-based Alzheimer's disease and related dementias screening tests beginning January 1, 2028. The bill explicitly defines these tests as FDA-cleared or approved genomic sequencing blood tests or equivalent blood-based tests. This is not an authorization bill with a spending ceiling — it mandates coverage under existing Medicare Part B, meaning CMS must establish a reimbursement rate (likely under the Clinical Laboratory Fee Schedule) once the bill becomes law. The money trail is structural: Medicare covers approximately 60 million Americans aged 65+. Blood-based dementia screening is currently a cash-pay or limited private-pay market. Mandatory Medicare coverage would make these tests available without patient out-of-pocket costs (after deductible), dramatically expanding the addressable patient population. The bill does not authorize a specific dollar amount; instead, it creates a new mandatory spending category within Medicare Part B. Estimated annual Medicare spending could range from $1B to $3B depending on utilization rates and the final CMS payment rate. Structural winners are Labcorp ($LH) and Quest Diagnostics ($DGX). Both have existing FDA-cleared blood-based dementia tests on the market. Labcorp's test (amyloid tau panel with NFL) and Quest's AD-Detect both target the exact population and test type described in the bill. Smaller diagnostics players ($QDEL, $RVTY) are also in the blood diagnostics space — QuidelOrtho has a cardiac/neurology assay portfolio, and Revvity operates in the applied genomics space — but neither has a directly comparable FDA-cleared blood-based dementia screening test, making their benefit less direct. Their recent 30-day price declines (-29.7% for QDEL, -5.27% for RVTY) reflect broader sector weakness, not dementia-specific headwinds. The legislative timeline: the bill is in early stages, referred to Energy & Commerce and Ways & Means in the House. Companion bill S3267 was introduced in the Senate. With 82 cosponsors and bipartisan sponsorship, the bill has strong early support, but must pass both chambers and be signed into law before the January 1, 2028 effective date. The most likely passage window is late 2026 or mid-2027. Investors should monitor committee hearings and markups as key catalysts.