Federal health officials on Friday gave the state the go-ahead to start rejecting applications from some needy for free health care.
Cindy Mann, director of the Center for Medicare and Medicaid Services, said that, beginning this coming Friday, the state need no longer enroll childless adults in the Arizona Health Care Cost Containment System. In a letter to AHCCCS Director Tom Betlach, Mann said her agency "regrets" the state's decision but said it is totally within Arizona's right to alter its eligibility.
Attorney Tim Hogan of the Center for Law in the Public Interest, said Friday there is nothing he can do to stop that change, at least not immediately. On Thursday, Maricopa County Superior Court Judge Mark Brain rejected Hogan's request for a restraining order, pointing out that no one was in imminent danger because no one seeking care had yet been rejected.
Hogan said, though, that situation will change beginning this coming Friday when AHCCCS, the state's Medicaid program, begins turning away people who until then have been eligible.
"As soon as we have those, we'll be able to go back to court," he said.
The change is one part of a plan by Gov. Jan Brewer to cut the AHCCCS budget for the fiscal year that began July 1 by more than $500 million.
A 2000 voter-approved measure requires the state to provide free care to anyone below the federal poverty level, about $18,500 a year for a family of three.
That is more generous than what is required by the federal government which picks up about two-thirds of the cost. In fact, federal law does not require any coverage for childless adults.
Under Brewer's plan, any childless adult already enrolled by this coming Friday will be allowed to remain in the program. But anyone else will be turned away.
Monica Coury, an AHCCCS assistant director, estimated that 100,000 people will be affected in the first year. She figures this change alone will save the state about $190 million.
The other savings will come from changes the state wants to implement Oct. 1. These range from requiring co-payments for care and a 25-day hospital inpatient limit for adults to no longer enrolling some adults earning more than 75 percent of the federal poverty level, though their children will remain eligible.
Arizona also hopes to impose charges on those who smoke or are obese but do not follow medical advice to change their habits.
Even if Hogan does not get an injunction, Brain has agreed to hear more extensive arguments next month on the legality of the cutbacks.
Hogan contends that lawmakers are powerless to scale back the voter-approved program. He said the initiative amounts to a mandate to provide the necessary funds.
Attorneys for the governor and the state, however, say lawmakers need to supplement the proceeds from a tobacco tax and the state's share of a settlement with cigarette companies only when cash is "available." The state's budget crunch, they argue, shows there are no available funds.
Assistant Attorney General Kevin Ray also is asking Brain to rule that voters have no constitutional right to demand that future legislatures continue to fund programs. But Hogan responded that such a ruling would undermine the 1998 constitutional amendment forbidding lawmakers from repealing any voter-approved initiative.