States would be allowed the option to provide Medicaid coverage for women with breast and cervical cancer through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), if a new bill (S. 662/H.R. 1070) becomes law. The bill has bipartisan support in both the House and Senate.
Run by the Centers for Disease Control and Prevention, the NBCCEDP brings critical breast and cervical cancer screening and follow-up services and information to women at highest risk for these cancersolder women, the poor, the uninsured and underinsured, and racial and ethnic minorities. The program is restricted by federal law, from using federal funding for treatment services. To that end, states have developed various treatment systems that blend together a wide range of strategies, including use of public hospitals, access to county indigent care funds and hospital community-benefit programs, and individually negotiated payment plans. But funding for these treatment approaches is ever more doubtful.
The Senate version of the proposed bill gives a state the option of including a woman who tests positive for either of those two cancers in its Medicaid program, but only for the duration of the cancer treatment. Pam Dougherty, manager of federal government relations for the American Cancer Society (ACS), thinks that Congress may well pass this bill. However, she recognizes that the debate on funding treatment services will shift over to the state legislatures, since the federal proposal (S. 662) grants states only an option to pick up these services. The next challenge will be to convince the states that this option is critical for the continuation of a very important program.
Since the NBCCEDP program was established in 1991, there have been 1.7 million breast cancer and 951,000 cervical cancer screenings, serving over 1.2 million women who do not routinely seek health services. Dougherty says that the program is reaching only about 15% of eligible women. The NBCCEDP program is funded at $159 million for the current 1999 fiscal year. The Clinton administration has proposed the same figure for fiscal 2000. The ACS wants the budget increased to $215 million.