Cervical, breast cancer coverage facts

My turn

Posted: Monday, May 07, 2001

The diagnosis of cancer profoundly affects the involved person physically and emotionally. In addition, family and friends feel the emotional impact of a diagnosis of cancer. For those of us who have been through this experience, any discussion of it is particularly poignant, difficult and emotional.

Unfortunately, emotion has also impacted the debate to add women with breast and cervical cancer to a list of people whose treatment is covered by Medicaid. I would like to present some of the facts as discussed during the hearings on this legislation.

Since 1990 there has been a program through the National Centers for Disease Control and Prevention to provide free screening exams for breast and cervical cancer to women who meet eligibility guidelines. Last year Congress gave states the option to add Medicaid coverage for treatment of cancers diagnosed through this program. House Bill 65 was one of the bills introduced to add the coverage to Alaska's Medicaid program.

As the chair of the Senate Health, Education, and Social Services Committee, I was interested in gathering as much information as possible as we worked on the legislation.

During public hearings our committee was told that Alaska has the second highest rate of breast and cervical cancer in the United States. Lt. Gov. Ulmer referred to it as an epidemic. In response, our committee expressed concern about why the rate is so high in Alaska. Sen. Loren Leman, vice chairman of our committee, asked the Department of Health and Social Services if it had identified risk factors for these cancers that were especially prevalent among Alaskan women. The department identified several risk factors and acknowledged that it had other information that could be available.

When we reported a new version of HB 65 from our committee, it required the department provide annually to the Legislature a summary of risk factors associated with these diseases. We were all particularly interested in environmental links, as well as hereditary and behavioral factors, that might explain the elevated cancer rate among Alaskan women. This additional language said: "The Department of Health and Social Services shall report to the Legislature ... (1) the environmental, behavioral, or genetic factors that have been associated with the onset of the types of breast or cervical cancer diagnosed in the persons eligible for services under sec. 1 of this Act in peer-reviewed clinical studies published in periodical medical literature that have postulated an association between one or more of these factors and an increase in the incidence of breast or cervical cancer."

Clearly what was actually in the bill, as opposed to what was reported, did not make Alaskan women the subjects of a legislative study under HB 65.

The final version of HB 65 that passed the Senate on a 20-0 vote on May 5 contains a provision for annual reporting to the Legislature of data from the Alaska Cancer Registry and other sources available to the department. The department worked with us to clarify the data collection and reporting - and is encouraged by the increased interest in its cancer registry. This provision does not intrude upon the doctor-patient relationship and in fact does not create any additional information gathering beyond what the department already does under its agreement with the Centers for Disease Control & Prevention. As required by language in the Federal CDC/Medicaid guidelines, all information is confidential and cannot be identified with any single individual. This standard was further made clear in our committee discussions and on the Senate floor.

We worked on this legislation and voted to pass it from the Senate because we care about Alaska women. Not only do we want prompt treatment available for those of us who are diagnosed with breast and cervical cancer, but we also want to publicize those risk factors to help minimize the chances that our neighbors, our daughters, sisters, mothers, aunts, cousins or any other woman will ever get one of these diseases.

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