SACRAMENTO, Calif. - 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 - have sent a letter rebuking Gov. Arnold Schwarzenegger for the move, and state lawmakers are warning that people will die. Audits are being demanded. "Diagnosis delayed leads to death," said Assemblyman Pedro Nava, a Democrat from Santa Barbara.
At issue is an early December decision by the governor's 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 fiscal 2008-09.
"This is unacceptable," a bipartisan congressional group wrote Schwarzenegger earlier this month.
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 a 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. And no new patients will be enrolled in the program from Jan. 1 through June.
"It's a very extraordinarily difficult decision to make," said department spokesman Al Lundeen.
The screenings are funded mostly through revenue from a tobacco tax, 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.
The new rules come less than two months after a federal task force released a controversial opinion recommending that most women wait until 50 to receive routine mammograms, then get them once every two years. Administration officials said the changes to Every Woman Counts had nothing to do with those guidelines.
The governor wants "to cover as many women as possible," Schwarzenegger spokeswoman Rachel Arrezola said, as long as it "doesn't impact the state's already depleted general fund." California faces an estimated $20.7 billion deficit through June 2011.
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, said that "unlike the federal government, states cannot print money to solve its budget problems."