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June 13, 2017. Trump's proposed budget makes deep cuts in Medicaid spending. No matter your fiscal views, this study in Cancer explores some noteworthy potential consequences of such defunding. Women who seek Medicaid (i.e., seek care) only when something goes wrong have extremely high rates (nearly 65%) of advanced disease at diagnosis as compared to only 38.6% of patients with routine screening. A startling 1 in 5 patients without insurance present with metastatic disease, which is nearly 5x the rate for non-Medicaid insured patients (4.6%). And if tugging at the heartstrings doesn’t work, let’s talk purse strings. Average allowable costs in the year of diagnosis of an advanced breast cancer is > $129K as compared to $60-80K for early stage breast cancer. We would all be wise to remember that cutting Medicaid costs does not equal cutting healthcare costs.