[00:00:00] Adam Walker: From Susan G Komen, this is Real Pink, A podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.
[00:00:17] Susan G Komen stands alongside the rest of the cancer community with deep concern about proposed cuts in the federal budget, in addition to significant policy changes, which could impact access to high quality, affordable healthcare. It’s hard to weed through the information and to know where things stand at any moment in time.
[00:00:36] So joining us on the show today is Molly Guthrie. Komen’s Vice President of Policy and advocacy. Molly has intimate knowledge of what is happening at all levels of government and is gonna share some insight with us about what is truly going on, as well as what we can do to bring change to end breast cancer.
[00:00:55] Molly, welcome back to the show.
[00:00:57] Molly Guthrie: Thank you. It’s great to be here.
[00:00:59] Adam Walker: Well, I imagine now is quite the time to be a policy advocate and there’s a lot of advocacy to be done. I think there’s an overall feeling of uncertainty that we and fear right now. And as I talk with folks in the healthcare space with funding cuts in the news.
[00:01:17] So I appreciate you coming on the show today to bring some clarity. I think the place that I wanna start is to talk about how Komen addresses breast cancer on multiple fronts, including advocacy, because I don’t know if everyone knows this. So can you explain what Komen 360 Degree approach is and why addressing breast cancer in this way is so important?
[00:01:37] Molly Guthrie: Sure. So let’s start kind of from the very top. So here at Susan G Komen for our mission of ending deaths from breast cancer, we have two strategic priorities that drive our work. So the first one of those is conquering aggressive and metastatic breast cancers to ensure that people are living longer
[00:01:59] and better lives. And the second is ensuring that all people receive the care they need to achieve health equity. Both of those strategic imperatives and priorities are impacted by what you already shared. But Adam, what we do at Komen, again, is not limited to just public policy. So we have that comprehensive
[00:02:22] approach to benefiting and helping the breast cancer community. So the way we look at it in a 360 degree approach. Is really from four main areas. So one with education we want to make sure that people are empowered with evidence-based information so that they can make informed decisions and health decisions that support their, you know, personal preferences, their values, and their goals.
[00:02:52] In addition to education we have an amazing community health arm that provides direct patient care services to people that need them now. So really working on that immediate intervention to get people, you know, to their next treatment to help navigate the healthcare system. Just a phenomenal service that we’re able to offer to women and men across the country.
[00:03:18] We also have a very longstanding research arm, something that we’re, you know, very well known for. In our research at Komen, we invest in science and technology, but also conduct research that we know will drive equitable benefit to patients. Then finally, which we’ll obviously be talking a lot more about today, is our public policy and advocacy work, which really underpins
[00:03:46] those three other areas, you know. For better or for worse our public policy efforts and impact everything we do at Komen. And honestly, I think it’s become really clear to everyone that public policies, whether they be federal or state, they, they impact everything you do from, you know, the second you wake up to the second you fall asleep at night.
[00:04:08] Adam Walker: Yeah. Yeah. It’s a lot. And we’re gonna, and we’re gonna get into it, before we do I know you just returned from an advocacy summit in Washington, DC where there were lots of advocates that made their voices heard to lawmakers. What was the overall reaction to the group that you, what, like what reaction did you receive while you were there?
[00:04:28] Molly Guthrie: So overall, I would say the reaction was positive. I, I’d say the advocacy summit is a perfect example of the power of using your voice and actually communicating with your policymakers and their staff. So our annual event took place a little less than a month ago, and we brought in more than 200 advocates from 38 states plus DC.
[00:04:58] Those people held around 250 meetings on Capitol Hill. And so during those meetings, we were advocating for a few different policies. Some of the stuff that we’ll talk about later we didn’t know about yet. But the idea remained the same, right? Ensuring that we have appropriate funding for key
[00:05:18] programs and initiatives and that we’re implementing proactive policies that we know the breast cancer community needs. One of the reasons it was so important to continue to have this event this year and be on Capitol Hill is the importance and value of, again, being face to face with these lawmakers.
[00:05:38] You know, they are dealing with so many issues and their staff, you know. Just countless kind of endless numbers of issues that they’re dealing with. And so it’s easy in today’s climate, probably easier than it has been to forget about all the other smaller things and only be focused on the bigger things.
[00:06:02] But those smaller things can be in serious jeopardy now. And you know, putting a face to those issues, building those relationships so that we can call back and go back to those members when we do see the threats that we’ve seen over the last few weeks and few months.
[00:06:19] Adam Walker: Gotcha. Okay. Yeah, that, that’s good insight.
[00:06:22] And so I know top of mind for this community is a fear of research being frozen or stopped. I know your team’s been addressing this by advocating for funding with National Institutes of Health and Congressionally directed medical research programs. Do we know the status of what’s happening for fiscal year 26 yet in this area?
[00:06:44] Molly Guthrie: I would say fiscal year 26 is a little bit of a question mark where a lot of the information in the news that’s coming out now is actually based on the government’s fiscal year 25. So anyone that’s not, you know, living and breathing federal policy, because fiscal years are different depending on where you work, where you live.
[00:07:09] For the federal government, their fiscal year runs from October 1st through September 30th. Just to frame the time period. One of the reasons that this became a bigger deal, because even though the fiscal year started in theory in October, they didn’t law make, lawmakers didn’t actually fully do their job.
[00:07:36] They passed a what we call a continuing resolution that kicks the can down the road. And so we didn’t see the fiscal year 25 budget be actually passed until we were in the current calendar year. So we saw that happen earlier this year. And as part of that, there was a $20 million cut to the breast cancer research program at the DOD, which is one of those congressionally directed medical research programs you mentioned.
[00:08:09] But we’ve also seen through some different government means and methods a claw back or taking back of funds that were allocated by Congress for fiscal year 25 and other previous grants. And so that’s where we’ve seen freezing and cuts happen, especially at the National Institutes of Health. And unfortunately we continue to see that evolve and change. And beyond the funding side, there’s also been some pretty significant restructuring of how the NIH works and its different institutes and so it’s just been, it’s been a time of immense change. Complicated by a reduction in staff and a reduction in funding.
[00:09:00] Yeah. Complicating that even more is looking to fiscal year 26. So biomedical research, you know, specifically cancer research has always seen really strong bipartisan support. You know, Republicans, Democrats in the house and the Senate. The president historically have been, have championed this funding because of the impact it has on human life, right?
[00:09:30] Impact it has on the economy. So Congress is just starting the appropriations process, but as part of that, the administration, so currently the Trump administration releases their budget proposal, which directs Congress on what they would like to see.
[00:09:50] And so every administration does this.
[00:09:54] The Trump administration budget proposal included some shocking reductions. So when you look at NIH for example, it calls for a 40% reduction in overall funding. So we’re talking about $47 billion that they are requesting that congress goes away with. That’s gonna have significant issues and interference on research, on clinical trials like it, it would be truly devastating to see that go into place.
[00:10:34] The unknown is, will Congress follow the proposal that Trump put forth? Will they not? Will it be, be someplace in the middle. But we do know status quo today is that there are grants getting canceled. There are clinical trials that are being paused, halted. And there’s fear that much more of that Will Yeah.
[00:11:03] Will come.
[00:11:04] Adam Walker: Wow. Yes. I mean that, I guess there’s a good reason for stress and concern as that, as far as that goes. And I mean, appreciate you breaking that down. Is it true that some top researchers are considering careers outside of the US because of the threats to funding?
[00:11:25] Molly Guthrie: Yes. So it, it’s expensive to conduct medical research and in general.
[00:11:33] And so when you look at cuts to research grants, you know a lot of that cost comes from scientists that work in those labs. And so when you’re talking about cuts, you’re talking about elimination of positions in addition to equipment and other components. But the scientists, the researchers are a large portion of that, and so there’s a lot of concern.
[00:12:01] Yes, there will be impact on established scientists, but there’s, you know, more concern on what this will mean for people that are considered to be early career researchers, which is a bit deceiving because these are people that have already put in years and years of, you know, training and, you know, might have really great discoveries that they’re on the cusp on, but haven’t got to the point where they are receiving enough funding to have their own lab.
[00:12:31] And so there’s a lot of worry that those. Especially those researchers will look for opportunities outside of the US if there continues to remain this uncertainty, and especially if there’s that significant cut. There’s been some reporting the last few weeks across, you know, media platforms from
[00:12:56] really key leaders in the research field. And they’ve all expressed similar concern that, you know, for the u for the US for a long time, you know, we were the benefit of brain drain from other countries.
[00:13:13] And now we’re, you know, starting to see that we might be doing… shifting to a reverse brain drain and that, you know, we had all this great expertise and leadership and research discoveries coming from the US and now people are wanting to look to other parts of the world.
[00:13:35] And I I saw a report come out in the last week or so from a publication that surveyed scientist, it was for a scientific journal. The journal is nature and their findings were of the people that they surveyed, 75% of them, three quarters of them said that they would be open to leaving the US to work somewhere else.
[00:14:00] And you know, we don’t know for sure what it’s gonna look like, but the fear is there across the continuum. But especially those that are, you know, in the beginning stages or the younger part of their medical research careers.
[00:14:16] Adam Walker: I don’t think I ever considered any of that. And that feels to me like a very significant side effect of these cuts.
[00:14:26] The, I mean the brain, like, wow, There. I don’t know if I have any words. Yeah.
[00:14:33] Molly Guthrie: Well, we worked so hard, to build what we have here. Yeah. And to bring be the place that other countries were sending their best and brightest. Yeah. And to lose that, you know it would, it just would, it would be horrible that it would set us back, you know, decades and decades.
[00:14:51] It’s also not something that, you know, we can just quickly undo.
[00:14:55] Adam Walker: Yeah.
[00:14:56] Molly Guthrie: Yeah. You can’t turn research on and off and it would, it’s going to take you years and years to build back what we potentially are losing.
[00:15:07] Adam Walker: Oh, that’s wild. All right. Well, I mean, continuing down this path I know I, because don’t like the next question either but I’m there bad news.
[00:15:18] I’ve gotta, I’ve gotta ask it. So I mean, I get the next question I have to ask is about the, you know, the budget proposed by the Trump administration calls for the total elimination in federal funding for the National Breast Cancer and Cervical Cancer Early Detection program. So what would that mean for early detection, especially for people in communities that are underserved?
[00:15:40] Molly Guthrie: Yes. So another area that I have seen bipartisan support for decades. This program was started in 1991. It’s something that Komen has been around for and advocating for since day one. So something that’s really core to, you know, the breast health continuum that we know in the US today. The BSEP program, what we lovingly call it so we don’t have to repeat the long name..
[00:16:12] It is known because it provides screening and diagnostic services to low income women who either don’t have insurance or have insurance that they still have to pay too much to get that screening and diagnostic testing done that they need. And then if someone is detected that they do have a cancer detected through the screening program, they are also able to then navigate someone into treatment and so that they’re able to do something with their diagnoses.
[00:16:43] It has just had a truly phenomenal impact. Impact in breast cancer, if you look at just one side of the program, right? You know, in the 30 ish years that it’s been in existence. It serves six and a half million women. It’s provided more than 16 screening tests for breast cancer, and most importantly, it’s diagnosed almost 81,000 breast cancers.
[00:17:13] So we’re talking, you know, tens of thousands of breast cancers that would’ve not been detected, had if this funding, you know, didn’t exist. And you know the bigger. Not even bigger because these are all big concerns. But you know, the worry is, we know the breast cancers don’t just go away because there’s not a program to catch it.
[00:17:40] And you know, people are either, you know, either are not gonna get their cancer detected at all and die from their cancer, or they’re gonna put it off until they can’t ignore it anymore. Until they see. A tumor protruding out of their chest, or the pain is so bad that they go to the emergency room and you know by that time it’s stage three,
[00:18:02] stage four. Yeah. Breast cancer when it is very, you know, different treatment, a more aggressive treatment, the outcomes are worse, but more importantly, it’s very expensive to treat. And yeah, you know, especially with the screening program, it’s a really shortsighted cut if the idea is to have cost savings, right?
[00:18:27] Yeah. And it’ll eliminate waste, which is part of the argument for it and that we you know, it’s a proven program that’s diagnosing cancers earlier. It’s saving the taxpayers and the government money. Yeah. So if we do away with it, not only is it going to, you know, be devastating when it comes to early detection and access to care, but it’s gonna be more expensive for all of us in the long run.
[00:18:58] Adam Walker: I mean and just, I just wanna make sure I got the number. So it’s 81,000 early detections had this program not existed, would’ve gone to worse outcomes, detection much later, much more expensive. I mean, detrimental in a number of different ways to, to people, to families, to society in general, right?
[00:19:20] Molly Guthrie: Yes.
[00:19:21] Yeah and you know, one other uplifting commentary to, to add. So it’s had an amazing impact, but it still hasn’t even seen its full potential. So what we spend so much time, what we have prior to this year spent so much time advocating for at Komen is to actually increase the funding for this program because how it’s funded now.
[00:19:49] We only serve about 13% of the eligible population when you look at, for the breast health services. So it’s woefully underfunded already that’s still been able to have amazing amazing results and, you know, save lives and save money. But we could be doing so much more and the infrastructure is there, you know, there’s just, there’s so much more that we should be doing rather than fighting to have
[00:20:15] the program, you know, even exists in the first place.
[00:20:19] Adam Walker: Wow. And that’s why you’re continuing to advocate. You know that’s a good reason to continue to advocate. So I know there was recent coverage about a budget reconciliation, e effort being passed in the House of Representatives.
[00:20:34] What is that and how is access health coverage in jeopardy? And what could this mean for breast cancer outcomes?
[00:20:43] Molly Guthrie: Yes, I think it was just last week, the house of Representatives passed a bill that the name is legitimately called a big, beautiful bill. And so this bill was done through the budget reconciliation process, which is common.
[00:21:04] Anytime there’s a new president that comes in, they typically use this process to pass policies that were promised during the campaign. The big difference with budget reconciliation is that in the Senate, when you pass bills, you typically need a two third, two thirds of the Senate to vote yes.
[00:21:26] For budget reconciliation, you simply need a majority in both the House and Senate to get the bill done. Okay. And so it’s easier to pass policies that might be divisive, right. However, the constraint on the budget bills is that there has to be a kind of a tie to budget. And so at least originally the data coming out is proving that not to be true, but originally all of the policy proposals that were put forth had to be offset by cost savings.
[00:22:04] Okay. You know the Republican leadership had said it was a priority to make sure this budget, the bill was at a minimum budget neutral, ideally saving money. You know, I improving our deficit.
[00:22:22] To get the level of savings that they needed there was really only one way to do that because Trump had called on, leadership in the House and Senate to not touch Medicare and Medica, Medicare and Social Security. The only other place that you can pull really, that has a lot of money in it for services is Medicaid.
[00:22:46] And the budget reconciliation path, but Bill that was passed, the big beautiful bill included. You know, hundreds of millions of dollars in cuts to Medicaid. Medicaid alone wasn’t able to get them to the dollar point that they needed. So it also included some provisions that will make it harder for people that get their health insurance from the marketplace that was established as part of the Affordable Care Act, right?
[00:23:15] So if you get insurance, not private insurance, but you’re not getting it from your employer. Most people are getting it from their marketplace, which might have a different name depending on where you live. But it’s gonna be a lot harder to get access get through that process. And they also implemented if this bill passes the Senate, which you know, remains to be seen, but the House bill in addition to cutting some funding, one additional layer was added and that it. Instituted a work reporting requirement that has proven not to be successful in states that have implemented this.
[00:24:00] Again, the idea of waste, fraud and abuse. It turns out that’s not where a lot of the waste and fraud is coming from Medicaid. But our big concern is people. So I talked about the screening program earlier, that it gets navigated into treatment, right? That’s through the Medicaid program.
[00:24:21] You know, work reporting requirements are going to be burdensome for whomever, but it’s a, an even worse situation for someone that is using Medicaid because they were diagnosed with breast cancer and now in addition to their breast cancer, they have to worry about proving that they’re working or that they aren’t working because of their medical condition, and they’re having to do that every six months.
[00:24:45] And if they don’t do it, then they lose, you know, lose coverage for the treatment that they need to continue to live. And so the impact is real. I think the impact is scary for those of us that work in patient advocacy and know the barriers that our communities face. The good news again is that it so far is only
[00:25:11] one third of the way there, it still has to pass the Senate. It still has to be signed into law by the president. And you know, they didn’t get the bill text until right before they had to vote. And so now that, you know analysts have had more time with the bill, we’re learning that, you know, it likely will actually add money to the deficit.
[00:25:35] You know, what it, the true impact that it will have and communities. And so it’s not totally clear right now what action the Senate will take. You know, if they change it significantly, then it has to go back to the house. The household was only able to pass it by one vote. Gotcha. One vote in the dark of night is when it was.. Gotcha.
[00:25:56] Was passed. So not great. But there’s still time to, you know, use your voice to be heard and Right. It was voices of the patient advocacy community that actually made it better than it could have been. You know it’s not great, but it could have been a lot worse.
[00:26:14] Adam Walker: Yeah. So Molly with everything that’s going on, which is a lot.
[00:26:20] And I know because this is a short podcast, you haven’t even covered it all necessarily but with everything that, that we’ve talked about what does all of this potentially mean for the future of breast cancer and will this have any impact on Komen’s focus?
[00:26:39] Molly Guthrie: So I think that when you’re looking at the future of breast cancer outcomes, breast cancer care, there is, there are real impacts in all of these areas.
[00:26:50] So if we see cuts and research that’s gonna prohibit probably future innovation and future cures that could have come to market on the screening program. If the funding were to go away, that’s gonna remove an access point for, you know, millions of women and men across the country. If the budget reconciliation moves forward, it creates barriers and, red tape and administrative burden for people actually accessing Medicaid and private health insurance, which means, you know, how will people get health, healthcare, you know, their outcomes will likely be worse. It’s unfortunately a multi-pronged, like layered on. Layered on layered, yeah
[00:27:39] problems to the breast cancer community. Like Komen is doing what we can to step in. But the levels of funding and programs and reach that the federal government has, no one organization is gonna be able to, to swoop in and do it on their own. So we have proven programs. We have proven interventions that we know work.
[00:28:08] You know, we’re funding as much research as we can. On the policy front, you know we’re continuing on, you know our priorities remain the same. However, we have to have had to spend a bit more time doing defensive work than proactive. Yeah. because even, you know, today we know the healthcare system isn’t perfect.
[00:28:31] You know, there are a lot of really important policies that we would like to drive forward to improve healthcare, but federally we’re having to do a lot of that. That defensive. Yeah. Work right now. Well Molly, I think we can talk about this quite a bit longer, but but I think I’ll stop us here.
[00:28:50] Adam Walker: If we’ve got some listeners that are fired up, ready to get involved, wanna make their voices heard, what should they do right now?
[00:29:01] Molly Guthrie: I mean, I think the biggest takeaway that I can say is to use your voice, right? Like I think it’s easy to turn off the news or to disconnect right now because there’s so much going on.
[00:29:14] There’s, you know, what feels like kind of an endless barrage of bad news. But our lawmakers in Washington, DC work for us. You know we pay their salaries and we need people to not get disenfranchised, right? We want people to, to participate in the process and use their voice and reach out to their elected officials.
[00:29:40] Komen.org, we have a section on our website devoted to advocacy and there’s a lot more information there, including an opportunity to sign up to be what we call an advocacy insider, and we make it really easy. Once you sign up, you’ll get email updates only on our advocacy work about times when we need you to use your voice.
[00:30:03] When that vote happens in the senate on that, the budget reconciliation, you know, reach out to your senator now? Yeah. Or just the budget process. The fiscal year 26 budget process that we talked about earlier. There are very specific times when your voice can be even more impactful and we try to make that as easy for people as we can.
[00:30:25] But, you know, use your voice. But stay engaged in the process and make sure that your lawmakers are hearing from you. Yeah. Because they’re hearing from a lot of people right now. When we were on Capitol Hill, those staffers looked exhausted. You know it’s not an easy time to do this work.
[00:30:45] Yeah. And so they’re hearing a lot, but that doesn’t mean that we shouldn’t be there advocating for the breast cancer community, because if we’re not, then no one else is going to be, and there it’s gonna be that you know, issue that, that kind of gets forgot about and the mess of everything else going on.
[00:31:02] Adam Walker: Yeah, that’s right. Get involved, go to the Komen website, look up the advocacy section and get involved. Molly, thank you for your time today. Thank you for the role that you’re playing. It’s so important now, I think more than ever. And really appreciate you joining us on the show today and breaking everything down.
[00:31:20] Molly Guthrie: Thank you. Sorry. Sorry for not more good news, but I look forward to my future appearance talking about all the good. That’s right.
[00:31:28] Adam Walker: That’s right. And I’m gonna hold you to that, the future appearance. All the good policy news. It’s gonna be great. It’s gonna be great. Wonderful.
[00:31:39] Thanks for listening to Real Pink, a weekly podcast by Susan G Komen. For more episodes, visit real pink.Komen.org. And for more on breast cancer, visit Komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam. You can find me on Twitter at AJ Walker or on my blog adam j walker.com.