Faced with an irony in current law that entitles low-income women to be screened but not treated for breast and cervical cancer, Congress agreed last year to let states expand Medicaid to cover these women. But fiscal constraints threaten to keep many states from moving ahead on the issue.
Cases like Lisa's inspired Congress to pass the Breast and Cervical Cancer Treatment Act of 2000. Signed into law by former President Bill Clinton last October 24, the measure gives states the option to provide Medicaid to eligible women who have breast or cervical cancer.
If states elect to use the new option, it would fill a gap in existing benefits for low income women that enables them to be diagnosed but not treated. Currently, low-income women in all 50 states can get screened under the National Breast and Cervical Cancer Early Detection Program , which is run by the Centers for Disease Control and Prevention (CDC). But if a woman is found to have breast or cervical cancer, it's a crapshoot whether she'll get treatment without health insurance.
Some states, such as Maryland, have programs to pay for treatment, while many others, including Indiana rely on charity care programs or kind-hearted doctors who'll foot the bill.
In current legislative sessions, 23 states are debating whether to expand Medicaid benefits to cover the women in question, according to the National Conference of State Legislatures (NCSL) .
"Clearly it's a very popular issue, but I think the hard part is getting states to figure out where the money comes from because Medicaid budgets are so stretched this year. The real battle for lawmakers will be whether they want to add another entitlement," says NCSL policy specialist Stephanie Wasserman.
With the new program in place, women would have a primary care doctor and would not have to pay in full for things like certain prescription drugs and family planning services and supplies.
In Indiana, State Rep. Vaneta Becker is cosponsoring a measure that would keep women like Lisa from ever having to lie again.
Forty-six low-income women were diagnosed with cancer through the CDC's program last year, and estimates show there will be 85 this year, Becker says.
Becker says she has "a lot of support" for her bill, but her colleagues are also concerned about the state's budget. "Revenue is tight this year, and the program will cost $427,000. I'm not going to give up, because I think it's important. But the fiscal situation is making it tough," Becker says.