California Breast and Gynecological Cancer Treatment Task Force

During 1999-2002, Marj served as lead consultant for the California Breast and Gynecological Cancer Treatment Task Force. This statewide collaboration among breast cancer, public health and women’s organizations created a program that has grown to be $2 billion public health program providing life saving treatment to thousands of women each year.

The Task Force set out to remedy a deadly problem. California’s state government paid for screening tests to diagnose low-income women for breast and cervical cancer, but after diagnosis, there was no money to pay for uninsured women’s treatment.

Jackie Speier, then a state Senator, convened the task force to provide advice about state government funding of a program to serve these women.

Under Marj’s leadership, the Task Force generated recommendations. These included that the program should offer:

  • Full access to comprehensive health care (not just cancer care) for individuals diagnosed with breast or gynecological cancers,
  • Extensive coverage of cancer treatment without arbitrary cut off dates,
  • Patient care coordination to ensure quality of care,
  • Point-of-Service eligibility,
  • Minimal co-payments/out-of-pocket expenses,
  • Eligibility for the working poor (up to 300% of the federal poverty level),
  • Eligibility for the underinsured (those with high co-pays or deductibles) as well as the uninsured,
  • Open to all California residents (including the undocumented).

Marj also oversaw the development of an opinion poll that showed widespread public support for state funding for breast and cervical cancer treatment for low-income women. And with the Task Force members, educated the public and communicated with policy makers about this program.

In June 2001, then-Governor Gray Davis signed the legislation that created the Breast and Cervical Cancer Treatment Program. This public health program, while not including everything the Task Force had recommended, is still a model for the nation. It includes a Medi-Cal component that provides access to comprehensive health care while low-income women are receiving breast and cervical cancer treatment and coverage for women under 200% of FPL (one of the highest eligibility levels for public health programs in California). While not able to convince the legislature and Governor to include undocumented women, men with breast cancer, and those with high co-pays and deductibles in the MediCal program, they were able to ensure a state-only program (the first of its kind in the nation) to at least provide the cancer treatment necessary for those individuals.

Marj Plumb subsequently provided advice and consultation to the California state government on program options and implementation.