Medicaid coverage shouldn’t discriminate
Published: Sunday, August 14, 2011
Updated: Sunday, August 14, 2011 17:08
About a month ago, a man from South Carolina named Raymond Johnson was diagnosed with breast cancer. Unable to afford the cost of chemotherapy, Johnson applied for a type of Medicaid that specifically provides financial assistance to breast cancer patients. However, his coverage for the several chemotherapy treatments, which each cost about $10,000, was denied because he is a male.
The policy of denying Medicaid coverage to male breast cancer patients has been called "discriminatory" by the South Carolina Department of Health and Human Services. I agree.
In order to receive Medicaid, there are certain eligibility requirements that must be met, such as United States citizenship, proof of state residency and having limited assets and/or income. Along with these mandatory requirements, someone applying for Medicaid must also fall into another Medicaid Eligibility Category that specifically targets their reason of need for Medicaid coverage. The two breast cancer policies that were available for Johnson to apply for, Best Chance Network or Non-Best Chance Network, completely exclude men from the picture. The eligibility requirements are written in reference to a "she." For example, "she is under the age of 65" or "she has been screened for breast or cervical cancer under the Best Chance Network program." It seems that the policy does not even recognize the fact that men can and do develop breast cancer.
Cancer does not yield to gender, so why do Medicaid policies and requirements not reflect this view? Even though women are more likely to be diagnosed with breast cancer, 2,000 men are diagnosed with the deadly disease every year, and that number only represents 1 percent of cases, according to the American Cancer Society.
Johnson knows he will be financially devastated after the completion of his chemotherapy treatments.
His gender should not have been the deciding factor in the denial of his coverage for breast cancer treatments.
Women are also being discriminated against in the health care arena.
In 2008, under Blue Cross Blue Shield of California, women were being charged twice as much as men for the same health insurance coverage. Los Angeles Times columnist David Lazarus said this practice of making women's health insurance premiums more expensive was "purely a matter of Blue Shield deciding that women, as a general rule, are more expensive to insure than men." He goes on to ask that if gender is to be considered a risk factor, why aren't other genetic factors included as risks? For example, "If women are more expensive than men to insure, and middle-aged women are significantly more expensive than middle-aged men, what about, say, older women with red hair? After all, they have fairer skin and thus are more susceptible to skin cancer."
The list of "risk factors" used in building insurance coverage policies could go on forever, but at some point that list of risk factors would turn into a discriminatory list of whom insurance companies believe will live the longest based on genetic and lifestyle choices that could be considered as "risk factors." So, if factors other than gender, such as race, were to be included on that list, the insurance policy would be deemed as racially discriminatory; but then again, why don't insurance companies consider gender to be a discriminating risk factor at all?
A person's gender is not a pre-existing condition, nor is it a reason to be denied from receiving Medicaid. Insurance and Medicaid policies should match this outlook, and treat their applicants with the gender equality that they deserve, and the coverage that they need.
There is some good news, however. One major insurance policy does recognize the need for gender equality in health care. The Affordable Care Act, signed into law last year by President Barack Obama, ensures that women will not pay more than men for the same insurance policies. It also turns out the policy that prevents Johnson from receiving Medicaid coverage for his breast cancer treatments is in direct violation of the Affordable Care Act.