Wisconsin Delays Cutbacks To Cancer Program For Low-Income Women After Uproar

WASHINGTON -- Wisconsin Gov. Scott Walker's (R) administration announced Friday evening that it was delaying its controversial restructuring of a popular health care program for low-income women, after an outcry from women's health advocates.

The Wisconsin Well Woman Program provides preventative health screening services to low-income women who are uninsured or underinsured. It has been credited with providing more than 500,000 breast and cervical cancer screenings to more than 70,000 women.

The system is designed to help women locally, with a "coordinating agency" in each of the state's 72 counties aimed at helping women navigate the system of more than 1,000 participating providers.

But in December, the state Department of Health Services notified participants that the entire system was set to change on July 1, blaming the Affordable Care Act. The federal health care reform law requires employers to fully cover many preventative services, such as mammograms and certain chemoprevention drugs, and the state believed that women in WWWP would leave the program and get coverage through Medicaid or the federal marketplace.

Under the new system, there would be only five to 10 coordinating agencies in the state, and only a handful of health care providers. Although the restructuring was set to go into effect in just a few months, the state hadn't said who those providers would be, causing significant consternation among advocates, coordinators, providers and patients who were unable to schedule follow-up appointments because they didn't know which doctors would be available and how far they might have to travel.

In a memo Friday evening, Karen McKeown, Wisconsin's public health administrator, announced that the state was putting those plans on hold until more data could be collected on how the Affordable Care Act would affect WWWP. A new structure for the program is now set to be in place July 1, 2015.

"[S]takeholders in the provider and coordinator communities have reached out to us with questions, concerns, and suggestions about how the proposed model would work. We have listened carefully, and have modified our original proposal based on those concerns," McKeown wrote to local health offices, WWWP providers and WWWP coordinators.

By Dec. 1, the state will begin to select the providers who will form the new network. By April 1, 2015, it plans to have the new structure of providers and regional coordinators in place, with everything up and running by July.

"We are very pleased that the Department has decided to take some time to talk to stakeholders and make sure they do this right and that the integrity of the program will be preserved," said Dawn Anderson, executive director of the Wisconsin Breast Cancer Coalition, who co-wrote a letter to Walker expressing concern about the changes. "We're just really happy that our advocates spoke out loudly enough that the Department listened."

Sara Finger, executive director of the Wisconsin Alliance for Women's Health, said she was "grateful" that the state listened to the outcry from women's health advocates.

"At this point, we want to be sure the current provider contracts are extended at least through the end of this year so the women currently being treated through the program can receive continuity of care and are able to schedule their six month follow up appointments with a known provider," Finger added.

Many women's health advocates in the state understood that there would probably be some changes to WWWP due to the Affordable Care Act. But what confused them was why it was happening so quickly, with no input from stakeholders. In an interview with The Huffington Post last week, WWWP Director Gale Johnson was unable to give a straight answer explaining the need for such a short timeframe. She admitted the state had no projections on how many people would be leaving WWWP to go into the federal health care marketplace or into BadgerCare, the state's Medicaid program.

McKeown said in her memo Friday that the state would work to collect more data over the next year.

"In addition to allowing our partners more time to prepare for the transition, this will allow the Department to predict with greater precision how many women will enroll in BadgerCare Plus or a Marketplace health insurance plan and will allow the Department to modify its proposal based on clearer projections for the number of women who may potentially be served through the WWWP," McKeown wrote.

McKeown also pledged that no woman will have to travel more than 50 miles for screening services.

Walker has been a vocal opponent of federal health care reform and was one of the Republican governors who rejected federal funds to expand Medicaid to more residents in the state. Finger said that between now and the final restructuring, she would like to see the state invest more resources into helping individuals navigate the Affordable Care Act.

"It's incredibly important that the state keep its commitment as noted in today's memo to gather the necessary data for women currently enrolled in the program and to truly invest the time, resources and efforts to work with these women to transition them into the appropriate health care program," Finger said. "We have yet to see this administration fully commit to making the Affordable Care Act work in Wisconsin and sincerely hope politics are put aside to ensure health care reform works for all Wisconsinites especially the women served by this important program."