California lawmakers protest state’s mammogram cutbacks

The dollars saved are nearly negligible, but the political costs of scaling back breast cancer screening for tens of thousands of low-income women have turned out to be huge.

Twenty-one members of California’s congressional delegation -- Republicans and Democrats alike -- have sent a letter rebuking the governor for the move. State lawmakers are warning that people will die. Audits are being demanded. The Assembly Budget Committee chairwoman is even organizing a symbolic bake sale.

“Diagnosis delayed leads to death,” said Assemblyman Pedro Nava (D-Santa Barbara).

At issue is an early December decision by the Schwarzenegger administration to stop providing free breast cancer screening for those under age 50 and to freeze new enrollments for six months starting in the new year. The changes inject a “cruel level of confusion,” Nava said, for poor women seeking breast exams in the Every Woman Counts program, which served 311,000 in the 2008-09 fiscal year.

“This is unacceptable,” a bipartisan congressional group wrote to Gov. Arnold Schwarzenegger earlier this month. Eliminating free screenings, they warned, was “ultimately placing more women at risk of dying from breast cancer.”

Roughly 1.2 million women are eligible for the program, advocates say, though far fewer receive the free mammograms. Single women earning up to $21,600 per year can sign up. The income limit for a woman in a family of four is $44,100.

“It’s even more depressing that poor, uninsured women are the ones being impacted by this,” said Deb Weintraub, who does public outreach for the Los Angeles branch of Susan G. Komen for the Cure, a breast cancer advocacy group.

Schwarzenegger’s Department of Public Health is rewriting the rules so only women older than 50, up from the current minimum age of 40, can qualify. No new patients will be enrolled in the program from Jan. 1 through June 2010, as well.

“It’s a very extraordinarily difficult decision to make,” said department spokesman Al Lundeen.

The screenings are funded mostly through tobacco tax revenue, which has shrunk along with the number of smokers in the state, he said. In addition, the sour economy has made more women eligible -- and driven more to seek the free service.

“We wish we could supply the screening,” Lundeen said. “We cannot afford to supply the screening.”

The new rules come less than two months after a federal task force released a controversial opinion recommending that most women wait until age 50 to receive routine mammograms, and then get them only every two years. Administration officials said the changes to Every Woman Counts have nothing to do with those guidelines.

The governor wants “to cover as many women as possible,” said Schwarzenegger spokeswoman Rachel Arrezola, as long as it “doesn’t impact the state’s already depleted general fund.” California faces an estimated $20.7-billion budget deficit through June 2011.

The hot-button issue of curtailing free mammograms for the poor has resonated from Sacramento to Washington, D.C. The 21 California members of Congress decried the cutbacks of the partly federally funded $61-million program as “penny unwise and pound foolish.”

Schwarzenegger, in a sharply worded retort, chided the Congress members that “unlike the federal government, states cannot print money to solve its budget problems.” He urged them to focus on bringing home more federal money for the state.

In the state Capitol, Democrats are demanding that the governor reverse the decision. Schwarzenegger’s staff counters that the Legislature was warned about the cuts more than six months ago.

Nava, the Santa Barbara assemblyman, said he would request a formal audit to ferret out what he believes is mismanagement in the mammogram program. The chairwoman of the Assembly Budget Committee, Noreen Evans, has scheduled an oversight hearing next month as well.

“These are women who can’t afford to go and buy a mammogram,” said Evans (D-Santa Rosa), who estimated that the program needs an additional $16 million. “This is a program of last resort.”

Evans is hoping cooler heads -- and warm muffins -- will prevail come January. The Legislature’s women’s caucus, she said, is organizing a bake sale next month to raise money for, and awareness of, the cause.

“It’s a shame it has come to this,” she said.