Sarah and Emily have a lot in common. They’re about the same age, they’re both home health aides, and they work for the same healthcare facility on the Louisiana-Texas border. Both have been offered the same company healthcare plan, but they’ve declined it because they can’t afford the premiums.
There’s one big difference between them, though. Sarah lives in Louisiana; Emily is just across the state line in Texas. Strange as it may sound, that puts Emily at higher risk of breast cancer.
That’s because Sarah’s home state of Louisiana recently expanded Medicaid, which provides free screening mammography to facilitate early detection of breast cancer. A vital part of the Affordable Care Act, Medicaid expansion serves to close a “coverage gap” that denies reasonably priced healthcare to many Americans on low incomes. Texas, on the other hand, has rejected Medicaid expansion.
This past July, Sarah enrolled in Medicaid. For the first time in her adult life, she has health insurance. Emily, though, was forced to make a grim choice: either purchase a plan she couldn’t afford, or do without health insurance.
Medicaid Gave Sarah Peace-of-Mind
One in eight American woman will develop invasive breast cancer in her lifetime. An estimated 246,000 new cases will be diagnosed in 2016, along with another 61,000 cases of non-invasive (in situ) breast cancer. Death rates from breast cancer are second only to lung cancer.
Sarah’s family has a history of breast cancer, so she receives a mammogram under her Medicaid insurance. Her mammogram shows no signs of cancer, but through genetic testing, she discovers that she carries a mutation of the BRCA1 gene. Together with the BRCA2 mutation, BRCA1 is responsible for five to ten percent of all breast cancers.
Emily, meanwhile, knows that the United States Preventative Services Task Force recommends that women receive a mammogram every two years after age 50. But she doesn’t have insurance, and she simply can’t afford to pay for a mammogram or genetic testing herself.
In non-expansion states like Texas, Emily and other low-income women are about 25 percent less likely to be screened for breast cancer than peers in states with Medicaid expansion. Because mammograms detect breast cancer in 80 to 90 percent of women who have it, the disease is much more likely to go unnoticed without regular screenings.
But thanks to her Medicaid coverage, Sarah has learned she’s at risk. Now, she’s following her doctor’s advice to minimize her chances of developing breast cancer. Emily, on the other hand, must do without this support unless Texas changes its stance on Medicaid expansion.
Take Better Care of Your Breast Health
If you’re in Emily’s situation, what should you do to decrease your chances of developing breast cancer?
1. Practice habits that reduce your risk.
To reduce the risk of breast cancer, the National Breast Cancer Foundation recommends that all women maintain a healthy weight, stay active, eat fruits and vegetables, limit alcohol consumption, and avoid tobacco. All women should perform monthly breast self-exams to monitor for any lumps, pain, or changes in shape.
2. See if you qualify for the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).
The Centers for Disease Control provide low-income, underserved, and uninsured women with access to breast exam diagnostic services. Since 1991, NBCCEDP has provided more than 12 million breast examinations to almost 5 million women.
3. Learn more about Medicaid.
Approximately 3.8 million uninsured Americans qualify for Medicaid. If you’re uninsured, then check Medicaid’s eligibility requirements to see if you could receive low-cost, comprehensive care that pays for mammograms every 1-2 years.
More than 40,000 women die of breast cancer every year in the United States. So this October, take steps to decrease your risk, and if you live in a non-expansion state, encourage your state legislators to embrace Medicaid expansion. We owe it to our mothers, sisters, and daughters to do more to fight breast cancer.