Rauner blasted for proposed cuts in cancer screening program

Without the Illinois Breast and Cervical Cancer Program, Janna Sullivan says she almost certainly would have delayed or avoided getting the screening X-ray that found cancer in her right breast and led to successful treatment nearly five years ago.
Sullivan, a Springfield resident, was 61 at the time and was uninsured while she worked a minimum-wage job full time at a local retailer. She said she was grateful for the program. It saved her hundreds of dollars in costs on mammograms over the years and thousands of dollars in treatment costs.
“People really need this,” she said Friday, adding that she remains cancer-free. “If you get one more year with your family, you’re lucky.”
Sullivan joined other women’s health care advocates in criticizing Gov. Bruce Rauner’s proposed 71 percent cut in state funding for the program in the fiscal year that begins July 1. They called on the General Assembly to turn down or soften the proposed $9.8 million reduction.
If put into effect, they said, the new Republican governor’s proposal would lead to almost 50 percent fewer low-income women being screened by the program and longer waiting lists, all resulting in delayed diagnosis of cancer and earlier deaths.
“This program was established as a lifeline for people who may have cancer,” said state Rep. Greg Harris, D-Chicago, chairman of the House Appropriations-Human Services Committee. “I don’t want to cut that lifeline.”
The governor, facing a multibillion-dollar budget deficit, also included in his proposed cuts the repeal of a state law enacted in the early 2000s that gave uninsured women automatic Medicaid coverage for treatment costs of cancer detected through the 20-year-old screening program.
That savings is estimated at about $32 million annually in state and federal Medicaid dollars.
“If instituted, the cuts would definitely be the largest ever in the program’s history,” said Anne Marie Murphy, a former director of the state’s Medicaid program who now is executive director of the Metropolitan Chicago Breast Cancer Task Force. “The effect would be that some women would die because they would get their care delayed — significantly delayed.”
Administration points to health law
The State Journal-Register requested an interview with a member of the Rauner administration. Rauner spokeswoman Catherine Kelly instead responded with an emailed statement: “With the implementation of the Affordable Care Act, women who may have used the program have now migrated to expanded Medicaid or to the Illinois Marketplace where they can find comprehensive health care and not just a stopgap measure.”
Kelly declined a request for additional comment.
The federal health care law’s expansion of federally funded Medicaid eligibility, along with the law’s federal subsidies for reduced-price private health insurance, do justify more downsizing in the screening program, which has been reduced in recent years — but not at the level Rauner suggests, a spokeswoman for the American Cancer Society Cancer Action Network said.
“The program is still very, very important,” said Heather Eagleton, the network’s Illinois director of government relations.
Because of language barriers, literacy and other issues, many women haven’t applied for the expanded Medicaid program, she said.
And for women whose annual household income is above the Medicaid threshold — 138 percent of the federal poverty level, or about $16,243 for an individual — some haven’t applied for subsidized private coverage because premiums and other out-of-pocket costs still make the coverage unaffordable, Eagleton said.
Those women will continue to delay screening, she said. And if they do get screened and the tests find cancer, some women may learn they are eligible for the Medicaid expansion, but the monthslong delays in receiving a Medicaid card could disrupt treatment, Murphy said.
Women with cancer diagnoses who earn too much for Medicaid wouldn’t be able to sign up for subsidized private coverage right away through the state’s health insurance exchange if they weren’t diagnosed during the once-a-year enrollment period, she said.
These disruptions in women’s cancer care “would be harrowing and possibly deadly,” Murphy said.
‘A lot of people need this’
The screening program provides free mammograms, breast exams, pelvic exams and Pap tests to uninsured women.
A total of 25,150 Illinois women are expected to be screened through the fiscal year that ends June 30. From 2007 to 2012, the state program detected 727 invasive breast cancers and 1,490 cervical cancers and precancerous lesions.
The program in the current year is projected to spend $13.8 million in state general revenue funds and $6 million in federal dollars.
For fiscal 2016, Rauner has proposed a program that would screen 13,000 women with $4 million in state money and $6 million in federal funds.
Private not-for-profit organizations, such as Susan G. Komen for the Cure, provide free screenings for women, but those groups probably wouldn’t be able to fill the gap created by Rauner’s cuts, Eagleton said.
The state program and private programs don’t meet all the needs for screening, she said.
Despite the Affordable Care Act, the cancer society says more than 192,600 women in Illinois lacked access to cervical cancer screenings in 2014, and more than 80,000 women lacked access to breast cancer screenings — all because of lack of insurance or high out-of-pocket costs in insurance plans.
When Janna Sullivan was diagnosed with breast cancer, her employer didn’t offer health insurance, she couldn’t afford to buy a private policy, and her husband, a self-employed swimming pool contractor, was uninsured as well.
Within weeks of the diagnosis, she underwent a partial mastectomy to remove the early stage cancer at Memorial Medical Center, followed by six weeks of daily outpatient radiation treatment. She never saw a bill because all of the treatment cost was covered through her automatic enrollment in Medicaid.
Sullivan now is retired and raising her 2-year-old grandson. Her husband, Tim, 55, who is unemployed, was able to enroll in the expanded Medicaid programlast year.
Janna Sullivan said Rauner’s proposed cut in the screening program “scares the hell out of me.”
“A lot of people need this. They don’t have the insurance. They don’t have the money,” she said. “It helped me. I might not be here talking to you without it.”
— Contact Dean Olsen: dean.olsen@sj-r.com, 788-1543, twitter.com/DeanOlsenSJR.