Feds' Medicaid suggestions not the prescription Brewer seeks - East Valley Tribune: Politics

Feds' Medicaid suggestions not the prescription Brewer seeks

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Posted: Thursday, February 3, 2011 11:00 pm

The Obama administration is offering states a chance to make their Medicaid programs more flexible -- but not the one thing sought by Gov. Jan Brewer.

In a letter Thursday to governors, Health and Human Services Secretary Kathleen Sebelius her agency recognizes that states are looking for ways to pare their Medicaid programs to cope with rising costs. With the federal government picking up about two-thirds of the price tag for most states, her agency would have to approve any changes.

Sebelius promised "responsiveness and flexibility,'' along with a quick response to any requests.

Sebelius already has one from Brewer. She wants to scale back the Arizona Health Care Cost Containment System, the state's Medicaid program, to eliminate care for most of those who are not required by Medicaid laws to be covered.

There are currently about 1.2 million people enrolled in AHCCCS, with the state's cost this fiscal year at more than $1.4 billion. That makes it the second largest single item funded with $8.2 billion in state tax dollars, with only aid to education costing more.

Brewer's request would eliminate care for about 280,000 AHCCCS recipients, mainly childless adults whom Medicaid does not require states to cover.

Arizona, whose voters approved expanding eligibility in 2000 to everyone below the federal poverty level, is now stuck with the more generous program. That's because last year's national health care law requires states to maintain programs as they were on that date.

Brewer wants a waiver from that mandate.

But that list of things Sebelius said Thursday her agency might approve, like modifying what benefits are offered, cutting fraud and providing preventative care to avoid high-cost medical conditions does not include scaling back eligibility. That left Brewer disappointed.

"You should be aware that Arizona has previously enacted or is pursuing every one of these suggestions,'' the governor wrote to Sebelius. In fact, Arizona implemented the first managed care version of Medicaid in 1982 while other states were paying doctors and hospitals on a fee-for-services basis.

Brewer said Arizona already has one of the lowest per-capita costs.

"Our problem is not with a bloated state structure,'' the governor wrote. "It is with federal mandates that leave us with no discretion to make reductions our budget -- and our Constitution -- demand.''

Brewer also repeated her request for a face-to-face meeting with Sebelius to discuss Arizona's specific problems.

There are currently about 1.2 million people enrolled in AHCCCS, with the state's cost this fiscal year at more than $1.4 billion. That makes it the second largest single item funded with $8.2 billion in state tax dollars, with only aid to education costing more.

Brewer's request would eliminate care for about 280,000 AHCCCS recipients, mainly childless adults whom Medicaid does not require states to cover.

Sebelius, in her letter to governors, said she is reviewing what authority she has, if any, to waive the requirement in the last year's national health care law for states to maintain their Medicaid programs as they existed.

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