Ten years after Congress enacted a law establishing a program to provide screening for breast and cervical cancer to underinsured and uninsured women, the House on May 9 overwhelmingly passed, 421-1, a bill (H.R. 4386) to provide treatment to women diagnosed under the program. Calling House passage of the measure “a great Mother’s Day gift for American women,” Rep. Sue Myrick (R-NC) added: “[Women] are going to have that peace of mind that they will receive the care that they need. If we care enough to screen the women, we certainly should care enough to be able to provide treatment.”
The Breast and Cervical Cancer Treatment Act, is sponsored by Reps. Myrick, Rick Lazio (R-NY), and Pat Danner (D-MO). Both Reps. Myrick and Danner were recently diagnosed with breast cancer and are undergoing treatment for the disease. “Our diagnoses were followed immediately by treatment because we both had insurance to cover us….Unfortunately, there are many women who do not have the ability to pay for treatment after being diagnosed with breast or cervical cancer. This is a most tragic situation that this legislation seeks to address,” stated Rep. Danner.
H.R. 4386 would give states the option of providing treatment through Medicaid for women diagnosed with breast or cervical cancer under the Centers for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Created in 1990 under the Breast and Cervical Cancer Mortality Prevention Act (P.L. 101-354), the NBCCEDP provides screening for breast and cervical cancer to underinsured and uninsured women. Though screening is authorized under the law, treatment is not.
The bill is similar to a measure (H.R. 1070) approved by the House Commerce Committee on October 28, 1999 (see The Source, 10/29/99, p. 1). That measure, sponsored by Reps. Lazio and Anna Eshoo (D-CA) would have provided an enhanced federal match to cover 75 percent of the cost of the program and states would be required to contribute 25 percent of the costs. However, as introduced, H.R. 4386 did not originally include the enhanced federal match. Last minute negotiating by advocacy groups resulted in the reinstatement of the enhanced match, but in order to properly fund the bill, sponsors pushed back the enactment date to 2001.
Expressing concern about the process by which H.R 4386 was brought to the floor, Rep. Eshoo stated that the original bill “was gutted and thrown by the side of the road last week,” adding: “I want to salute everyone in the House that was a cosponsor of H.R. 1070. That was the legislation that really allowed this to happen today.” Rep. Lazio countered, “I am proud of the leadership in allowing us to bring this to the floor to finally address this.”
H.R. 4386 does retain language—authored by Rep. Tom Coburn (R-OK)—from H.R. 1070 dealing with human papillomavirus (HPV). The measure would require the CDC to study the prevalence of HPV as well as to develop an education campaign on the disease. Condom manufacturers also would be required to put labels on condoms stating that they will not prevent HPV and that HPV can cause cervical cancer.
Rep. Henry Waxman (D-CA), ranking Democrat on the House Commerce Committee, expressed concern about condom labeling. Saying that the provision was “well-intended,” Rep. Waxman stated, “From a public health point of view, this provision will not achieve a meaningful improvement in health or in the prevention of HPV. On the contrary, it threatens to discourage the use of condoms in preventing other sexually transmitted diseases, including HIV and AIDS.”
Rep. Coburn responded saying, “It is true that 15,000 women will be diagnosed with cervical cancer this year….But hundreds of thousands of women will be treated for precancer dysplasia because we, as a government and health policy, have decided we are not going to let everybody know about the most dangerous sexually transmitted disease out there.”
