Thousands of breast cancer patients on Medicaid could lose access to health care following the Senate’s passage Tuesday of President Donald Trump’s “Big Beautiful Bill.” The measure is now headed to the House.
The American Cancer Society warns the reductions will “make it harder for many people to receive preventive services and cancer screenings, cancer treatments and health care in survivorship.”
“I believe that people are going to die,” said Dr. Rachel Greenup, chief of breast surgery at Yale’s Smilow Cancer Hospital.
U.S. Sen. Chris Murphy said on social media the bill “kicks 17 million people off of their health care. There’s going to be thousands of people who die in this country because they lose their access to health care.”
Under the bill, The Congressional Budget Office said nearly 12 million more Americans would become uninsured by 2034.
The White House is pushing back on criticisms of the bill, calling it “one of the Democrats’ most disgusting lies.”
But in a letter to ranking Senate leaders, researchers at Yale University and the University of Pennsylvania warn the cuts will lead to the loss of more than 50,000 lives.
The researchers attribute the potential spike in preventable deaths to Medicaid disenrollments, loss of marketplace coverage, rollback on nursing home staffing rules and the expiration of tax credits in the Affordable Care Act.
Despite the potential cuts to Medicaid, Greenup assured patients there are financial assistance programs available.
“There are also wonderful programs outside the hospital that will help pay for rent, electricity, gas, [and even] cleaning services to help mothers when they're sick from chemotherapy,” she said.
Greenup said with good treatment, these working-age individuals could ideally get back into the workforce and back to their normal lives.
'A lifeline for me'
Six years ago, at the age of 33, Deltra James, who is Black, was diagnosed with an aggressive form of cancer – stage 4, triple negative breast cancer.
Black women are 40% more likely to die from all types of breast cancer compared to white women. That’s despite being diagnosed with breast cancer at similar rates, according to a recent study published in the Journal of Clinical Oncology. The findings point toward racial disparities, not biology, driving the differences in cancer death rates.
“The intersection of being a Black woman, a young woman, and having triple negative breast cancer does place women at extra-high risk of having financial hardship as well as poor mortality,” Greenup said. “There's great data [showing] that when any cancer patient experiences extreme financial hardship, they are at a higher risk of cancer death than those who do not.”
While James sought treatment at Smilow for her cancer, Greenup said oncologists see women avoiding recommended therapies, or cutting back on expensive life-extending immunotherapies for cancers like triple negative breast cancer.
“[The treatments are] extraordinarily costly, especially for people who need to be on those drugs long term,” Greenup said.
“Patients who lack employer-sponsored health care, have high-deductible insurance plans, or are not yet eligible for Medicare can fall through the gaps, were it not for Medicaid,” she said.
James, who said she had no family history of breast cancer, credited Medicaid as being a “lifeline for me, a saving grace.”
“When I had to have a lumpectomy or the treatments – the infusions that I’ve had to sit and endure, and everytime I’m in that chair, the thousands of dollars that it costs. I had other things to think of, like child care,” she said.
An advocate for change
As potential Medicaid cuts loom, James and Greenup are now working together to save lives by promoting financial awareness.
The pair have collaborated on a video to educate breast cancer patients on available resources and to reassure women that help is available – if they ask.
“Individuals don't ask for financial support because, number one, they're so focused on survival,” Greenup said. “They want to take the treatment their doctor recommends. And there is a cohort of patients that worry if they can't afford care, they might not get care, and that's based on historical and justifiable mistrust from the health care system.”
“So we are working to empower individuals going through cancer treatment to be part of the solution by early outreach and support,” she said.
In the video, breast cancer patients talk about financial distress.
“Cancer is so expensive, it breaks you,” one patient said. “Food, buying clothes, if you have children, you have to have to pay for them. Rent, utilities, everything becomes so difficult mentally to deal with. How am I going to pay these bills? I can’t work.”
James said she will take her outreach about help available to cancer patients to churches and hair salons.
“That is a very common place, especially for my community, Black women, because we are there every two weeks,” she said. “Having conversations since my diagnosis [has] been important to me, like sharing within my own family and being really open.
“That's a big part of takeaway [from the video],” James said. “The shame of diagnosis and the shame of struggling and saying, ‘Hey, I really need help.’”
