The state of California is cutting back its coverage of mammograms for uninsured, low-income women, citing a budget shortfall.
The California Department of Public Health announced that beginning Jan. 1, it will raise the eligibility age for breast cancer screening services from 40 to 50 years for women in the Every Woman Counts program. The state-run program provides free clinical breast exams, mammograms, pelvic exams, and Pap tests to uninsured women with incomes at or below 200% of the federal poverty level. As an additional money-saving measure, the state suspended new enrollment for breast cancer screening for 6 months.
The program is facing “unprecedented fiscal challenges” due to increasing demand for breast cancer screening and declining state tobacco tax revenues, which are the program's primary funding source, Dr. Mark Horton, department director, said in a statement. Even though the state has made short-term cash infusions over the last few years to try to keep the program solvent, it has not been enough to keep up with the demand.
“By making fiscally responsible programmatic changes, we are working to ensure this program continues to be available to as many low-income women in California as possible,” Dr. Horton said.
The move came about a month after the U.S. Preventive Services Task Force issued a statement recommending biennial screening mammography for women aged 50-74 years. The task force's controversial recommendation said that the decision to begin regular screening before age 50 should be an individual one. However, the California Department of Public Health cited only cost as the reason for its decision.
Women's health advocates were quick to object. Donna R. Sanderson, founder of the California Collaborative of Susan G. Komen for the Cure, said the cuts effectively create a two-tiered system in California where women with insurance are able to access mammograms at a younger age.
Ms. Sanderson said the point of Every Woman Counts is to extend equal screening opportunities to low-income women without insurance. “Now it's not every woman counts, it's every woman counts who has insurance.”
Her group is calling on the state government to convene a stakeholders' meeting and provide more information about the program's financial situation. “Instead of making a general statement [that] because of the financial crisis in California we're cutting these services, we would really like more specific information on that,” Ms. Sanderson said.
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