Raymond Johnson was just 26 when he was diagnosed with breast cancer in South Carolina last summer. When he applied to a federal insurance program created to cover breast cancer treatment, he was denied. Why? Because he is a man.
Although breast cancer primarily affects women, men are also impacted by the disease. The American Cancer Society estimates that in 2012, approximately 2,190 new cases of invasive breast cancer will be diagnosed in men, and about 410 men will die of the disease.
Yet male patients are denied Medicaid insurance for breast cancer treatment, such as chemotherapy, because they are not women. The Breast and Cervical Cancer Prevention and Treatment Act of 2000 provides Medicaid coverage for treatment to patients who are diagnosed with breast cancer through federally-funded screening programs. Because only women can obtain routine screening through these programs, only women are able to receive coverage for their treatment. The federal Centers for Medicare and Medicaid Services have instructed state Medicaid agencies that male breast cancer patients are categorically excluded from coverage for treatment, even if they meet all other qualifying criteria.
Based on current medical guidelines and the prevalence of the disease in women, providing routine screening to women makes sense. What makes no sense is denying coverage for life-saving treatment to those already diagnosed with breast cancer, simply because they are men. The denial of benefits to patients based solely on their gender is a blatant violation of the Constitution and federal law.
The ACLU sent a letter to the federal Medicaid agency calling on it to extend Medicaid coverage to men who are diagnosed with breast cancer and otherwise satisfy program criteria. The federal government should not be enforcing an obviously discriminatory and unconstitutional policy, and it should not be directing states to do so either.
Tomorrow is World Cancer Day. Its 2012 theme — “Together it is possible” — reminds us that cancer crosses all gender, race, class, and geographic lines and that we must work in unity to treat and prevent it. Our government must recognize that patients should have equal access to breast cancer treatment, regardless of whether they checked M or F in a box.
Help us ask the Centers for Medicaid and Medicare to ensure equal access to breast cancer treatment.