This post has been updated
Kentucky needs to do more to shed its reputation as a cancer capital and prevent residents from falling prey to the disease.
That’s according to the American Cancer Society’s Cancer Action Network and its latest nationwide assessment of state efforts to protect people from cancer.
The report, “How Do You Measure Up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality,” uses a color-coded system to show how well each state is doing in various categories. Green means “doing well,” yellow means “some progress,” red means “falling short” and black means “no funding.”
Kentucky, where an estimated 25,990 people will be diagnosed with cancer this year, earned green for having increased access to Medicaid and for providing Medicaid coverage for people to kick their tobacco habits.
But the commonwealth fell flat when it came to providing money for breast and cervical screening, according to the network.
“There’s actually zero funding through the legislature this year for the breast and cervical cancer screening program, which means we’re going backwards because we’ve had it for several years,” said Pam Pilgrim, Kentucky’s lead ambassador for the network. “This was removed by Gov. Bevin this year, and we were hoping that the members of the legislature would put it back in, but in the end, it did not get back in.”
Although there are some other limited sources of funding, low-income women who might have otherwise gotten screened are being put at risk, Pilgrim said.
“A lot of these cancers are easily handled if they are diagnosed early,” Pilgrim said. But “a lot of people with cancer that do not have insurance or do not have access to funding for any of these screening tests do not go to get screened until they have symptoms” and sometimes, late-stage cancer, Pilgrim said.
Allocating more funding for screening could, ultimately, save money in the long run, she said, because treating advanced disease “is very expensive.”
Dr. Jeffrey Howard, the state’s public health commissioner, said in an emailed statement that Kentucky is committed to cancer prevention, including screening for cervical and breast cancer.
“These services are covered under the Kentucky Medicaid program, as well as all health insurance programs compliant with ACA (Affordable Care Act) guidelines,” Howard said. “Additionally, the screening and referrals are still available through the Kentucky Department for Public Health Women’s Cancer Screening program, which continues to receive federal grant funding to cover uninsured individuals who are income eligible.”
The state also has shown its support of cancer prevention in other ways, he said, noting that Bevin and “subsequently the legislature added $2.5 million in new pediatric cancer funding, and the legislature added $500 thousand for colon cancer this biennium.”
Howard also noted that cancer prevention services are one of the 10 essential benefits of the Affordable Care Act, also known as Obamacare.
But despite the act’s emphasis on prevention, “there are still people falling through the loopholes, and the Affordable Care Act is in danger every day,” Pilgrim said. “There are still a lot of people who do not have insurance.”
And many may lose their Medicaid coverage if the state’s plan to implement Kentucky HEALTH, the Section 1115 Medicaid waiver, ever goes forward, Pilgrim said. “We are very fearful.”
But Howard said Kentucky HEALTH is crucial as a future means of engaging, educating and incentivizing members to get preventive care and screenings. “Simply providing access to services is not enough to improve outcomes.”
The network found other issues of concern. Kentucky earned red (falling short) in these areas: smoke-free laws, tobacco-prevention funding and indoor-tanning restrictions.
Tougher policies in those areas is important because Kentucky is No. 1 in incidence and mortalities from cancer, according to the network.
Prohibiting smoking statewide in places like restaurants would reduce spending on the treatment for conditions, such as lung cancer, emphysema and damage from secondhand smoke, Pilgrim said. “There’s a myriad of diseases that could be prevented with smoke-free laws, especially lung cancer.”
The network, which will be lobbying in Frankfort, also would like to see the state increase the cigarette tax beyond the 50-cent hike that recently went into effect.
The state earned yellow (making progress) in the category of cigarette tax rates. It also earned yellow in these two areas: access to palliative care and having good pain policies.
Pilgrim said the state needs to do more to help people in pain who aren’t getting the help they need because of efforts to curtail the opioid epidemic.
“We fully agree that there needs to be something done about the opioid problem, but we also want to protect cancer patients and other patients that are dealing with chronic pain to be able to get the medication that they need and legitimately take them the way they’re supposed to be taken,” she said.