Despite the government’s platitudes that the U.S. Preventative Services Task Force’s (USPSTF) revised recommendations wouldn’t reduce women’s access to mammograms… they seem to be having that exact effect in California.

From KABC-TV in Orange County:

A state program that’s been paying for mammograms for thousands of uninsured women under 50 is cutting its coverage.

Many women fall through the cracks of the medical system and are not able to get mammograms regularly, if at all.

In north Orange County, approximately 6,000 women went through the YWCA program this year.

Most of these women come from low-income households, are uninsured, and are over the age of 40. They receive coverage through a state program called Every Woman Counts.

“The 6,000 women are women who fall through the cracks in the medical care system and do not get breast health except for this program,” said YWCA Executive Director Diane Masseth-Jones.

But the Every Woman Counts program is undergoing drastic changes. Physicians in California received a letter from the state this week. Starting next month, until July, no women will be allowed to enroll in the program. After July, only women 50 and older will be eligible. Women in their 40s will no longer be covered.

Last week’s Mikulski amendment in the Senate ensured that if health care reform passes, women whose doctors recommend that they begin mammograms before age 50 will still have access to first-dollar coverage, regardless of the USPSTF’s recommendations. But unfortunately, this doesn’t solve the underlying problem with the legislation. As my colleague Carrie wrote last week at

Breast cancer activists are politically powerful and well-organized. Few politicians will want to take a vote that could seem indifferent to their cause. But what about the scores of other diseases and treatments that government panels will be asked to consider? What this process tells us, from the panels’ original pronouncement to the political response of politicians, is that government officials will be in the position to determine what care should be available. The name for that process-no matter how much the bill’s proponents insist otherwise-is rationing.

Of course, health care has to be rationed. We can’t all afford to consume all of the health care we want without taking costs into consideration. But there is an important distinction between the kind of “rationing” that results from individuals making decisions based on their own resources and preferences and the kind of one-size-fits-all rationing of a government panel. We can address the problems associated with personal “rationing” by helping those who truly can’t afford to buy insurance or obtain services-and, certainly we don’t need to subject the entire health care sector to government micro-management to do so.

At the end of the day, wealthy Americans will be able to pay for access to services that government panels may reject. Government “recommendations,” once in effect, will hit the poor the hardest.