WASHINGTON, Jun 14 (Reuters Health) - Low-income, uninsured women whose
breast or cervical cancer is diagnosed through a federally funded screening
program could be eligible for Medicaid under legislation approved by the Senate
Finance Committee.
The bill could affect the 6,500 women who have been diagnosed through the
Centers for Disease Control and Prevention's (CDC) National Breast and Cervical
Cancer Early Detection Program since its inception 10 years ago. While that
program provides mammography and Pap smears to uninsured women with incomes
under 250% of the poverty level, it does not permit federal funds to be used to
treat those cancers. That has left the estimated 6,500 women who have been found
to have cancer scrambling to find charity care.
"For women who are diagnosed with cancer, which is bad enough, to then have
to fight to find treatment because it's not affordable, I think is
unconscionable," said Sen. Max Baucus, D-Mont., speaking as one of the 72 Senate
cosponsors of the measure.
The Senate bill differs somewhat from the version passed by the House in
May. While the House bill would encourage states to offer the optional program
by offering a 75-25 matching rate, the Senate bill is slightly less generous,
following the structure of the State Children's Health Insurance Program
(S-CHIP), which generally provides states a matching rate 15 percentage points
higher than their regular Medicaid rate, for an average of about 68% federal
funding.
But while the House bill would not begin the program until Oct. 1, 2001, the
Senate bill would take effect this Oct. 1. Said Sen. Orrin Hatch, R-Utah, "It
would be tragic to have to wait a year to implement something so important."
While the measure passed with no dissent, several senators expressed some
concerns. Senate Majority Whip Don Nickles, R-Okla., a member of the committee,
said he worries about the higher matching rate, which he said could result in
people with higher incomes being better able to qualify for Medicaid then poorer
people. "I'm afraid if we follow this path we're going to have 10 different
match rates depending on the disease," said Nickles.
Finance Committee Chairman Bill Roth, R-Del., also expressed concerns,
although he did support the bill. "I think there are very valid concerns about
creating disease-specific eligibility categories within the Medicaid program,
which would take this successful and important program away from its original
mandate," he said. But in this case, he said, "the new Medicaid eligibility
category created...is specifically linked to a unique and existing federal
screening program and must not, and will not, be viewed as a precedent for
extending Medicaid eligibility body-part by body-part."
