Reflecting on the Breast and Cervical Cancer Prevention and Treatment Act
Fran Visco, President of the National Breast Cancer Coalition, reflects on the 20th anniversary of this landmark legislation for women’s health care
Editors note: On October 24, 2000, President Bill Clinton signed into law the Breast and Cervical Cancer Prevention and Treatment Act. To mark its 20th anniversary, and in celebration of Breast Cancer Awareness Month, we spoke with Fran Visco, President of the National Breast Cancer Coalition about her reflections on this important achievement for women’s health care.
Tell us a bit about yourself and your connection to the Clinton administration.
In 1991, a group of women launched the National Breast Cancer Coalition (NBCC), bringing together diverse grassroots groups from around the country that were focused on systemic change and activism to end breast cancer. I had been diagnosed with breast cancer in 1987, when I was 39 years old, a partner in a law firm in Philadelphia, and a nonprofit volunteer. I was fortunate to get in on the ground floor of the breast cancer movement and was elected the first President of the NBCC.
In 1992, we met with Hillary Clinton and the Clinton campaign in Williamsburg, Virginia to talk about breast cancer advocacy. That started a bond with the administration that lasted for the next eight years. It was clear that breast cancer was a priority for President Clinton and the First Lady — and that they embraced and understood the importance of grassroots advocacy.
No administration before or since has done as much to help end breast cancer. From their leadership in helping launch the Department of Defense Breast Cancer Research Program, which has brought more than $3.7 billion federal funds to breast cancer science, to the National Action Plan on Breast Cancer and the CDC treatment act, President Clinton was by our side for every step of the movement. He has served as the honorary chair of our campaigns to end breast cancer and launched the Virginia Clinton Kelley Fund at NBCC, in memory of his mother who died of breast cancer while he was in the White House.
Can you help us understand the issue and why it was important that action be taken?
In 1990, Congress had enacted a law to provide free breast and cervical cancer screenings for uninsured and underinsured women. However, there was no treatment component. So each year thousands of women were diagnosed with breast or cervical cancer but had nowhere to turn for the care they needed.
For NBCC, that was unacceptable. We believed if the government was going to pay to find their cancers, it should treat them. We designed a bill that would move these women into Medicaid for all of their health care which would cover treatment for their cancers.
The Clinton administration clearly understood that this gap in policy had created an urgent problem and that our approach to solving it was necessary. From the Health Care Financing Administration (now the Centers for Medicare & Medicaid Services) to the Office of the Secretary of HHS, to the Office of the First Lady, to the Oval Office, every level of the administration worked with us — refining the bill, expanding support, and getting it enacted. President Clinton touted the need for the bill in an Oval Office radio address and he worked behind the scenes to arrange support for the legislation. He made it clear this was a priority.
What do you remember of the signing of the Act?
I was sitting in a meeting in Los Angeles when I received a call from the White House telling me that the bill had been signed. I actually started crying. I remembered back to the day that one of our advocates had identified the problem. I remembered how hard we had worked to address it. I remembered being in the Oval Office with the President of the United States, hearing him speak about the bill, and the need to help women get access to care. It was beyond moving.
A few months after the bill was signed, there was a celebration in the East Room of the White House. It was the final weeks of the Clinton administration and many grassroots advocates flew in from across the country to hear President Clinton speak about the impact of the law and to acknowledge their work. We reflected back to the first year of the administration when we had delivered 2.6 million signatures to President Clinton in that very same room, asking for a National Action Plan on Breast Cancer. Hundreds of advocates had joined, watching him accept and affirm the petition. There was so much excitement in that room.
What is the impact of the Breast and Cervical Cancer Prevention and Treatment Act?
In record time, all 50 states opted into the law and tens of thousands of uninsured and underinsured women had access to health care because of it. As a result of the law, policymakers also began to understand that finding someone’s cancer isn’t the only goal. We need to make certain that individuals also receive the right treatment — and that the treatment is evidence-based and affordable. Before this bill, that conversation wasn’t being had in Congress or the public with regard to breast cancer. The Clinton administration was key to changing that conversation.
What can we learn from it today?
We really thought that, by 2020, bills like this would not be needed. We thought that we would have universal access to quality health care for all. President Clinton brought that goal to the forefront during his administration and it remains a priority for NBCC to this day.
We continue to believe that there is too much emphasis on the “early detection” of breast cancer. We need more than only campaigns to get women screened. We need access to the right, affordable care. We still have a nation where too many women and men are not insured and do not have access to the health care they need. This should not be a struggle — it should be recognized as a right.
