Health care: I gambled with my life and got lucky. But too many Black women lose.

·3 min read

I was a single mother just starting law school when I found the lump in my breast.

The lump itself was scary enough, but my fear was magnified because I didn’t have health insurance. There was no way I could afford costly medical treatment. Nor could I afford the peace of mind of having the lump biopsied – there was a chance it was benign, but if it was malignant, I’d be labeled as having a preexisting condition.

So for the next three years, I gambled with my life. I went through law school, passed the bar, landed a job, and waited for 30 days until my new health insurance took effect. And every day of that three years, that lump was with me, not only in my breast but always, always on my mind.

When, finally armed with an insurance card, I had the lump biopsied, it was malignant. And my lack of health insurance had given that insidious cancer a three-year head start in the fight.

Amazingly, I beat the odds. I underwent radiation and chemotherapy, and I’ve been cancer-free for more than two decades now. But I’ll never forget how terrified I was by cancer and how angry I was at a health care system that did nothing to help.

Expand Medicaid, expand life

Today, 25 years after my own diagnosis, that system is still disproportionally failing to protect Black and low-income women from breast cancer.

Breast cancer is the second-leading cause of cancer death among Black women, claiming thousands of lives each year. Compared with white women, Black women may be more often diagnosed in later stages of the disease, when it’s tougher to fight. As a result, Black women are 40% more likely to die of breast cancer than white women. Among women younger than 50, the racial disparity is even greater.

As the head of the Mississippi Center for Justice, a nonprofit law firm that advocates for affordable health care, I see women every day fighting to survive not only cancer but also the health care system. As we commemorate Breast Cancer Awareness Month, our national and local policymakers need to do more than just wear pink ribbons.

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We need to make health care more affordable and accessible. Expanding Medicaid in the dozen states that refuse to do so would go a long way to help. The Affordable Care Act enabled every state to increase Medicaid eligibility to almost all adults with incomes up to 138% of the federal poverty level, while the federal government covers 90% of the costs. And yet, lawmakers in so many states, including my home state of Mississippi, have repeatedly rejected this lifesaving, affordable option.

Vangela M. Wade in Greenwood Cemetery in Jackson, Miss., in October 2014.
Vangela M. Wade in Greenwood Cemetery in Jackson, Miss., in October 2014.

Providing people with Medicaid coverage boosts cancer screening, which is critical to catching the disease at an earlier, less dangerous stage. Studies reveal that Medicaid coverage resulted in fewer women being diagnosed with late-stage, harder-to-fight breast cancer. An analysis of more than 30,000 cancer patients found that Medicaid expansion significantly reduced racial disparities in treatment access.

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The most convincing statistic? A study of 1.4 million people concluded that patients with early-stage breast cancer were 31% more likely to die within eight years in nonexpansion states than in states that expanded Medicaid.

In addition to expanding Medicaid, we must ensure that Black women actually get the care they need once they get to the doctor’s office. Compared with white women, Black women get subpar care. Black women often don’t get screened for cancer using the best available technology, or they get screened less often. Too often, Black women experience discrimination in the doctor’s office, making them less likely to carry out prescribed treatment regimens or return for ongoing care.

We need policies that help all women get the care they need.

I’m lucky to be alive today. But life and death shouldn’t be determined solely by luck.

Vangela M. Wade is president and CEO of the Mississippi Center for Justice, a nonprofit, public interest law firm committed to advancing racial and economic justice.

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This article originally appeared on USA TODAY: Black women don't get the cancer screenings we need. Too many die.