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F I S C A L I M P A C T R E P O R T

SPONSOR King

ORIGINAL DATE

LAST UPDATED

1-20-06

HB 204

SHORT TITLE Mammograms for Low-Income Women

SB

ANALYST Collard

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY06

FY07

$300.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Duplicates SB 13

SOURCES OF INFORMATION

LFC Files

Responses Received From

Health Policy Commission (HPC)

Department of Health (DOH)

SUMMARY

House Bill 204 appropriates $300 thousand from the general fund to DOH for the purpose of

providing mammogram and related diagnostic services statewide to low-income women 40-49

years of age who meet the department’s criteria for the New Mexico Breast and Cervical Cancer

early detection program (BCC).

FISCAL IMPLICATIONS

The appropriation of $300 thousand contained in this bill is a recurring expense to the general

fund. Any unexpended or unencumbered balance remaining at the end of FY07 shall revert to the

general fund.

DUPLICATION

House Bill 204 duplicates Senate Bill 13.

House Bill 204 – Page

2

OTHER SUBSTANTIVE ISSUES

DOH indicates the Centers for Disease Control and Prevention (CDC) designed the National

Breast and Cervical Cancer Early Detection Program (NBCCEDP) to supplement state level

breast cancer early detection efforts; the New Mexico BCC Program currently receives no state

funding. Currently, the only funds available for mammography and related diagnostic services

in the state come from the federal BCC program funded by CDC. The American Cancer Society,

the National Cancer Institute, the U.S. Preventive Services Task Force, the American Medical

Association, and other nationally recognized experts broadly agree that screening mammography

should begin at age 40. The BCC program can only use 25 percent of its federal mammography

funds for women under 50 years of age, as mandated by CDC. With its existing federal budget,

the BCC program is able to provide screening mammography to 1,500 women under the age of

50. The department indicates House Bill 204 would support screening mammography and re-

lated diagnostic services for approximately 2,500 additional women.

HPC research according to the New Mexico Breast and Cervical Cancer Early Detection Pro-

gram (NMBCCEDP) indicates:

•

The program provided 5,420 screening mammograms to women in 2005.

•

The program serves women who are low-income (<250% of poverty level) and uninsured

or underinsured, with a priority focus (based on current CDD funding restrictions) on

women ages 50-64.

•

253 providers participate in this program statewide and each provider bills the program at

the NM Medicare rate, which is a reduced rate compared to a providers “usual and cus-

tomary” rates.

•

Since 2002, the treatment of program women diagnosed with cancer through the

BCCEDP has been funded in most cases via an enhanced 18% / 82% state/federal match

through Medicaid.

•

With advances in modern medicine, the 5 – year survival rate for New Mexican women

ages 40-49 is 96.0% when cancer is detected in its early stages; however, when breast

cancer is diagnosed after it has spread (metastasized), the 5-year survival rate for the

same population drops to 54.3%.

The National Cancer Institute estimates that, based on current rates, 13.2 percent of women born

today (1 in every 7.5 women) will be diagnosed with breast cancer at sometime in their lives.

Estimated lifetime risk of breast cancer has gone up gradually over the past several decades and

because rates of breast cancer increase with age, estimates of risk at specific ages are even more

meaningful than estimates of lifetime risk.(Source: American Cancer Society Fact Sheet)

The Center for Disease Control and prevention stated that in 2004, an estimated 215,990 new

cases of invasive breast cancer would be diagnosed among women and an estimated 40,580

women would die of this disease. Seventy-five percent of all diagnosed cases of breast cancer are

among women aged 50 years or older. The

American Cancer Society

estimates that 211,240

women will be diagnosed with and 40,410 women will die of cancer of the breast in 2005.

According to the NM Department of Health (DOH) website, appropriation for mammogram ser-

vices to low-income women aged forty to forty-nine years will prevent cancer deaths and pro-

mote early detection. Women aged 40 years or older should have a screening mammogram every

1 to 2 years. Breast Cancer ranks second amongst cancers deaths in women. Although it is more

House Bill 204 – Page

3

common in women over age 40, younger women can also get breast cancer.

DOH also stated that older women and women with lower incomes have lower screening rates.

In New Mexico in 1999, 18.4 % of New Mexican women were living in poverty; in 2000, 26.7%

of New Mexican women aged 19-64 reported having no health care coverage; and in 1999

women accounted for 60% of the states uninsured adult population.

According to the U.S. Cancer Statistics: 2002 Incidence and Mortality report, which includes in-

cidence data for about 93% of the U.S. population and mortality data for the entire country, more

than 180,000 women were diagnosed with breast cancer in 2002, and more than 41,000 died

from the disease.

KBC/mt