How the “Big Beautiful Bill” Threatens Prostate Cancer Screening for Black Men and Vulnerable Communities

Prostate cancer is the second leading cause of cancer death among men in the United States. Early detection through screening saves lives. But for Black men, who are 1.7 times more likely to be diagnosed and more than twice as likely to die from prostate cancer compared to white men, access to affordable screening isn't just helpful—it’s critical.

As a Clinical Health Coach who has worked with Medicaid patients for the past eight years, I’ve seen firsthand how important coverage and cost transparency are for preventive care. The Save the Homies initiative, powered by my nonprofit My City My Health, was built to change outcomes for Black men in Iowa and beyond. But a new legislative action—known as the “Big Beautiful Bill”—could roll back that progress before we even get a fair shot.

This article unpacks how the Big Beautiful Bill affects prostate cancer screening, especially for the men who need it most. Based on current policy changes, expert input, and my own experience on the ground, here’s what every community member, health professional, and policymaker should know.

What’s Going On?

On July 4, 2025, Congress passed the “One Big Beautiful Bill”—a sweeping legislative act that restructured federal healthcare spending. Its impact? Major cuts to Medicaid and the Affordable Care Act (ACA). These cuts directly threaten access to preventive services, including prostate cancer screenings for men who need them most.

Health experts, community leaders, and cancer advocacy groups have raised serious concerns. Zero Prostate Cancer issued a statement you can read here.

Why It Matters for Black Men

Black men in the U.S. face the highest prostate cancer mortality rate of any demographic. That’s not a genetic coincidence. It’s the result of:

• Limited access to care
• Lower screening rates
• Later diagnoses
• Systemic inequities in health coverage

The “Big Beautiful Bill” adds more roadblocks for Black men to get screened early, when survival rates are highest.

What Changed Under the Law?

The Bill reduces:

• Medicaid and ACA subsidies
• State funding for free/low-cost screening programs
• Access to shared decision-making with doctors

It increases:

• Out-of-pocket costs for PSA testing
• Risk of late-stage diagnosis
• Health disparities in already underserved communities

The Role of Prostate Cancer Screening

Prostate cancer screening usually starts with a PSA (prostate-specific antigen) blood test. It’s fast, non-invasive, and cost-effective—when people can access it.

Early detection is the best way to beat prostate cancer. Without it, chances of survival drop significantly. But screenings require insurance, low-cost options, or free public programs. That’s exactly what the Big Beautiful Bill takes away.

The Impact on Real People

As someone who coaches Medicaid patients every day, here’s what I see:

• Men who want to get checked but can’t afford the visit
• Clinics cutting back outreach due to funding losses
• A growing distrust in a system that keeps moving the goalposts

When cost becomes a barrier, care becomes a privilege.

What the Data Suggests

📉 Screening rates are expected to decline
📈 Late-stage diagnoses are expected to increase
⚠️ Mortality rates could rise, especially for Black men

Prevention only works when it’s accessible. The Big Beautiful Bill makes early detection harder, not easier.

What Can Be Done?

For Health Coaches and Providers:

• Connect patients with remaining free/low-cost screening programs
• Partner with community health orgs for mobile screening events
• Continue shared decision-making conversations, even if access is limited

For Advocates and Community Leaders:

• Speak out about how policy affects public health
• Push for local and state funding to restore what’s been cut federally
• Support initiatives focused on Black men’s health

What Save the Homies Is Doing

🧬 Community PSA Screenings
🎙️ Educational campaigns through our newsletter, podcast, and film
📍 Pop-ups in barbershops, churches, and neighborhoods
🗣️ Storytelling to build trust, not fear

Our approach is local, culturally grounded, and designed with Black men in mind.

This Is Bigger Than a Bill

The Big Beautiful Bill shows what happens when short-term cost savings outweigh long-term community health. What’s at stake isn’t abstract. It’s real people, real families, and real outcomes.

We can’t afford to wait for another policy fix. We have to act now—together.

🧠 Know the Facts

✅ Early-stage prostate cancer has a 5-year survival rate of nearly 100%
❌ Black men are 2x more likely to die from prostate cancer
🩺 PSA testing is most effective when done early and routinely
💰 The cost of inaction is paid in lives, not just dollars

📣 Take Action

➡️ Read the full Zero Prostate Cancer statement
➡️ Share the Save the Homies Day Event
➡️ Share this newsletter with someone who needs to hear it

🧡 Final Word

The Save the Homies initiative isn’t about raising awareness for the sake of it. It’s about saving lives. If you or someone you love is a Black man over 40, get informed and get screened. We’ll keep fighting for access, equity, and early detection. We got us.

– Corey Dion Lewis
Clinical Health Coach | Founder of Save the Homies & My City My Health