If you’ve talked with people much about the ASAP Act, you’ve probably heard the question: The blood tests sound promising, but are they strong enough for ASAP?

The answer? Yes. 

By the standards used to judge screening tests, blood tests for Alzheimer’s are strong. What’s missing is permission — the legal authority for Medicare to cover it. That’s what the ASAP Act provides.

What a screening test is for. ASAP is about screening tests, not diagnosis. A mammogram doesn’t diagnose someone with breast cancer. It indicates the need for a closer look, and most of the time that closer look is reassuring. That isn’t a weakness; it’s the design. Screening casts a wide, sensitive net to catch as many as possible with a disease before they have symptoms. This wide net intentionally results in more false positive results that follow-up exams sort out. Screening accepts more false positives in order to identify as many as possible who actually have a disease. An Alzheimer’s screening test works the same way: it provides a signal to look more carefully, not a diagnosis.

The right evidence to evaluate screening tests. For screening, Alzheimer’s blood tests perform very well. Of the people these tests flag, roughly half to three-quarters truly have the changes of Alzheimer’s in the brain — that is a far higher share than for the mammograms, lung scans, and stool and Pap tests we rely on as the standard of care for cancer. 

This evidence that Alzheimer’s blood tests perform well for screening doesn’t just come from a single, small study. Large studies published in top medical journals agree. For instance, a recent 2026 meta-analysis of many of these studies in JAMA Neurology pooled nearly 7,900 cognitively healthy adults and found the test reliably detects Alzheimer’s in the brain before symptoms begin — a result that holds across different populations, test makers, and countries. The authors concluded, “plasma p-tau217 can reliably detect AD pathology in the preclinical stage” (Malek-Ahmadi et al., JAMA Neurology, 2026; note, “preclinical” is another way of saying “before symptoms”).

(For additional, more technical, details, you may wish to read this companion brief.)

It’s time to provide ASAP’s measured path to coverage. It is prudent to use caution while a screening test is new and the kind of evidence described above is still being gathered. This is how every screening test comes to be trusted, and clinicians urging care are right to do so. The ASAP Act embodies this deliberation. It doesn’t require Medicare to cover these tests. Instead, it removes the legal wall that today keeps Medicare from covering screening for people without symptoms, and then leaves decisions to the experts, where these determinations belong. With ASAP, the FDA makes the call on whether a test is cleared for screening, and CMS makes the call on whether Medicare should cover it. ASAP keeps the science front and center while preventing the law from becoming a barrier to good patient care by lagging behind it.

So why the urgency to pass ASAP? Because of the swift pace of science, and because those with dementia and their families can’t afford delays. Alzheimer’s, like many related causes of dementia, remains a terminal disease. These individuals are progressing now, and they cannot pause their disease as legislation languishes in Congress. These individuals need screening tests cleared by the FDA and evaluated by CMS to deliver the same “detect early, treat early” care that has long been the standard for other major chronic diseases. That’s why we must move fast.

It is time for ASAP. The evidence for Alzheimer’s screening blood tests is broad and strong. Today’s treatments work best early and these tests may make that possible. What’s missing is the same Medicare coverage pathway in place for so many other diseases, and that is exactly what ASAP will deliver.

Want the evidence behind this blog — the studies, the full comparison table, and the regulatory detail? See the companion brief: Are Blood-Based Biomarkers Ready to Screen for Alzheimer’s? An Evidence Brief.

This essay is for education and advocacy. It isn’t medical advice or a substitute for care from your own doctor. If you have questions about your health or about receiving an evaluation, please talk with your health care provider.