Report Title:

Breast and Cervical Cancer

 

Description:

Establishes a breast and cervical cancer treatment program for individuals who are diagnosed by the Hawaii breast and cervical cancer control program who are not eligible to receive Medicaid benefits for treatment, and for other underinsured or uninsured individuals with breast or cervical cancer, or both. Appropriates funds for the program. (HB68 HD1)

 

HOUSE OF REPRESENTATIVES

H.B. NO.

68

TWENTY-FIRST LEGISLATURE, 2001

H.D. 1

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO CANCER.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. In 1990, Congress passed the Breast and Cervical Cancer Mortality Act (Act), leading to the creation of cancer screening programs in all fifty states. No federal funds were authorized under the Act for treatment, only diagnostic services were funded. In 1997, Hawaii established its pilot program for the Hawaii Breast and Cervical Cancer Control Program (HBCCCP) under this Act. Approximately two thousand women have been screened through the Hawaii breast and cervical cancer control program since its inception. Thirty-five breast cancers have been diagnosed through the Hawaii breast and cervical cancer control program for a rate of cancer of 1.1 per cent, as compared with the national rate of 0.8 per cent for all other programs combined. Every year, the number of women screened increases dramatically. Native Hawaiian women with breast cancer have a disproportionately high rate of mortality; they also have the highest rate of new cancer cases in the United States. In addition, one case of cervical cancer has been recently detected.

One of the problems with the current program is that the screening is free, but there are no funds for treatment for certain individuals diagnosed with breast or cervical cancer, or both, in this State. This has caused significant problems in diagnosing uninsured and underinsured patients with cancer:

(1) Patients with no insurance, who seek treatment, have been billed at "fee-for-service" rates, leaving those most economically challenged to face insurmountable financial obligations; or

(2) Some patients have denied themselves treatment to avoid financial catastrophe, and may return in an advanced stage of cancer, increasing the overall costs of treatment.

Recognizing these difficulties, Congress and President Clinton have recently passed the Breast and Cervical Cancer Treatment Act, P.L. 106-354, whereby states provide coverage of treatment costs for eligible women diagnosed through their breast and cervical cancer screening programs through their respective State Medicaid programs. Further, states that choose this coverage will receive enhanced federal funding equal to the funding for the State Children's Health Insurance Program.

Federal Law prohibits Medicaid coverage of legal resident aliens who enter the United States after August 22, 1996 for the first five years of their U.S. residency. In addition, aliens who are not legal resident aliens are generally not eligible for Medicaid. Therefore, such aliens, even if diagnosed with breast of cervical cancer through the HBCCCP, would not be eligible for Medicaid coverage of treatment costs. The purpose of this Act is to address the needs of women who:

(1) Are resident aliens of Hawaii who are not eligible for Medicaid; or

(2) Would be eligible under this program except that they have health care coverage which specifically does not provide coverage of their cancer treatment.

SECTION 2. Chapter 346, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"PART . BREAST AND CERVICAL CANCER TREATMENT

§346- State funded breast and cervical cancer treatment:

(a) The purpose of this section is to establish a state funded program to provide coverage of cancer treatment for women who have been diagnosed with breast or cervical cancer by the Hawaii Breast and Cervical Cancer Control Program (HBCCCP), but who are not eligible for federal funded Medicaid coverage as provided by the Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA) of 2000.

(b) As used in this section, "Department" means the department of human services.

(c) Provision of services. The department shall provide state funded medical assistance, as appropriated by the legislature, to women who are eligible for services by the HBCCCP and are diagnosed with breast or cervical cancer through the HBCCCP but are not eligible for federal Medicaid coverage. The two groups of such women are those who either:

(1) Are resident aliens of Hawaii who are not eligible for Medicaid; or

(2) Would be eligible under this program except that they have health care coverage which specifically does not provide coverage of their cancer treatment."

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $1 or so much thereof as maybe necessary for fiscal years 2001-2003 for the breast and cervical cancer treatment program.

The sum appropriated shall be expended by the department of human services for the purposes of this Act. Should the appropriated sums be expended before the end of the second fiscal year, the coverage provided under this section shall cease for the remainder of that year.

SECTION 4. This Act shall be effective on July 1, 2001.