Gov. Jan Brewer proposed a new plan to cut health care costs without actually kicking anyone out of the program.
The plan would halt enrollment of any childless adults into the Arizona Health Care Cost Containment System, the state's Medicaid program. Federal law does not require states to provide coverage for these people.
Brewer said that, over 12 months, that will reduce AHCCCS rolls by about 100,000.
But anyone already in the system -- about 145,000 childless adults -- would not lose their coverage on Oct. 1 as Brewer proposed earlier this year to save $540 million to balance the budget.
"I m committed to getting Arizona s Medicaid spending under control, and we will,'' Brewer said in a prepared statement. "But we must be mindful of our friends and neighbors who are enrolled in AHCCCS and dependent upon it for care.''
To make up the difference, Brewer plans to start charging co-pay fees for some and increasing the co-pays for others who already are subject to the charge. She also wants a "no show'' fee for missed appointments and an end to providing free taxi rides for doctor visits in the urban areas of Pima and Maricopa counties.
The state also will reduce the reimbursement rate it pays to doctors and hospitals by 5 percent and pursue $40 million Brewer said Arizona is owed by the Social Security Administration for past eligibility errors.
Senate President Russell Pearce, R-Mesa, said he is still studying the plan. But Pearce said he is skeptical that the savings would be enough to balance the budget. The changes, especially the co-payment requirements, also would need federal approval.
Those hurdles aside, the move still could result in a lawsuit.
The coverage for childless adults was part of the mandate by voters in 2000 to provide free care for everyone below the federal poverty level, about $18,310 a year for a family of three. And the state constitution generally prohibits lawmakers from altering or repealing voter-approved programs.
Brewer, however, said the initiative provides that the expanded coverage would be financed through tobacco taxes, the state's share of a nationwide settlement with tobacco companies, "supplemented as necessary, by any other available sources, including legislative appropriations and federal monies.''
The governor said the state's deficit shows there are not other "available'' funds.