Colonial Settlement

New GAO Report Shows Unequal Access to Medicaid for Breast Cancer Treatment
Study Also Reveals 60% of Eligible Women Are Not Getting Screened

WASHINGTON--(BUSINESS WIRE)--A new report from the Government Accountability Office (GAO) confirms what many in the cancer community already knew: significant gaps in access to screening and treatment services exist both between states and within states, according to the Susan G. Komen for the Cure® Advocacy Alliance.

The study highlighted two troubling findings: 1.) due to a lack of funding, more than half of eligible low-income, uninsured and underinsured women are not receiving recommended breast cancer screening, and 2.) more than a dozen states have left in place restrictions to Medicaid coverage for breast and cervical cancer screening that effectively eliminate all but a small fraction of low-income women, leaving the rest with few, if any, options for assistance.

Whether you live shouldnt depend on where you live, said Ambassador Nancy G. Brinker, chair of the Susan G. Komen for the Cure Advocacy Alliance. Regretfully, this report confirms what weve long seen that your ability to be treated for breast cancer often depends on what state you live in, whether you live in a city or rural area, and even if you went to the right clinic.

In 1990, Congress authorized the Centers for Disease Control and Prevention (CDC) to fund screening and diagnostic services to low-income, uninsured and underinsured women, which led to the creation of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Ten years later, Congress passed the Breast and Cervical Cancer Prevention and Treatment Act (Treatment Act) to allow states to extend Medicaid eligibility to these same women if they were diagnosed with breast or cervical cancer. The Treatment Act was implemented at the state level, and as such, eligibility varied by state.

The Komen Advocacy Alliance, which has advocated at both the federal and state level to close the gaps in access, worked with Senators Max Baucus, Barbara Mikulski and Debbie Stabenow to request the study. According to the GAO report:

16 states, plus the District of Columbia, currently limit access to Medicaid coverage for treatment only to those women who were screened and diagnosed at a clinic that has received CDC funds under the NBCCEDP program. (Indiana, which is included in this number, recently eased its restrictions just prior to the publication of the GAO report thanks in large part to the collaborative advocacy of the Komen Affiliates in Indiana.)
Due to limited funding, state NBCCEDP providers only screen 15 percent of eligible women on average nationally.
About 26 percent are screened by other providers, such as free clinics and mobile vans, some of which are funded by Susan G. Komen for the Cure® Affiliates. Unfortunately, these resources are limited and often not available in rural or other underserved areas.
Shockingly, 60 percent of eligible women do not receive recommended breast cancer screening from any provider a disturbing revelation that is much higher than previously understood. Screening is important as 98 percent of women survive at least 5 years if their breast cancer is discovered early, before it spreads beyond the breast.
The increased restriction significantly limits the number of women who are able to enroll in Medicaid for their treatment. For example, South Carolina increased its enrollment of women who entered Medicaid through the Treatment Act from 162 women to 614 during the two years after they eased their restrictions in 2004.
Few statewide options for treatment are available to low-income, uninsured women who are diagnosed with breast or cervical cancer but ineligible for Medicaid under the Treatment Act. Komen Affiliates help to fill this gap in many communities.
I commend Senators Baucus, Mikulski, and Stabenow for their attention to this important issue, and I applaud the efforts of our Komen Affiliates across the country, from Indiana to South Carolina, that have successfully fought to ease restrictions, said Brinker. Yet our work is not done. Whether as a part of overall health care reform or independent of it, policy makers at all levels of government need to close these gaps and ensure all women have access to affordable screening and treatment.

The Susan G. Komen for the Cure® Advocacy Alliance (KAA) is the nonpartisan voice for over 2.5 million breast cancer survivors and the people who love them. Our mission is to translate the Susan G. Komen for the Cure® promise to end breast cancer forever into action at all levels of government to discover and deliver the cures.