Brewer's plan for AHCCCS cuts advances - East Valley Tribune: Politics

Brewer's plan for AHCCCS cuts advances

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Posted: Wednesday, January 19, 2011 8:16 pm | Updated: 6:42 pm, Wed Apr 20, 2011.

State lawmakers took the first steps Wednesday to ending free health care for about 280,000 Arizonans.

On party-line votes, the Republican majorities in both the House and Senate Appropriations committee directed the Arizona Health Care Cost Containment System to seek a waiver from federal laws which prohibit all states from scaling back their Medicaid programs. Action by the full House and Senate is expected Thursday.

Technically speaking, nothing in the legislation actually trims AHCCCS eligibility. That debate will start next month as lawmakers begin adopting the budget.

But Gov. Jan Brewer, who asked for authorization to seek the waiver, said the move is the first step to cutting care. And that move, she said, is absolutely necessary to help bridge the $1.1 billion deficit anticipated for the next fiscal year.

Even if Arizona gets the waiver, and even if lawmakers vote to cut AHCCCS funding, that won't be the end of the battle.

House Minority Leader Chad Campbell pointed out that the change effectively overturns a 2000 initiative which requires the state to provide free care for everyone below the federal poverty level, about $18,300 a year for a family of three. That is more generous than required by the federal Medicaid program which picks up about two-thirds of the cost.

Campbell predicted a legal challenge, citing a state constitutional provision which bars lawmakers from repealing or altering voter-approved measures.

But Rep. John Kavanagh, R-Fountain Hills, who chairs the House Appropriations Committee, predicted that would fail. He said there is enough legal wiggle room in the wording of that 2000 ballot measure to permit lawmakers to scale back the program and not run afoul of the Arizona Constitution.

The heart of the issue, though, is whether the Legislature should leave 280,000 people without state-paid health care. Rep. John Fillmore, R-Mesa, said Arizona can no longer afford to do more than required by federal law or is offered by most other states.

Rep. Russ Jones, R-Yuma, said he was not swayed by arguments for Arizona hospitals that cutting eligibility would be a financial disaster for them, with the newly uninsured now seeking their care in emergency rooms.

He said the 2000 expansion of AHCCCS eligibility was "like a windfall for the medical community,'' with taxpayers absorbing more of the burden for the uninsured. Now, Jones said, doctors and others will have to live with the same Medicaid rules and eligibility as more than 40 other states.

John Arnold, the governor's budget director, said Brewer is not leaving the doctors and hospitals in a total lurch. She has asked lawmakers to set aside $151 million next fiscal year to at least partially compensate health care providers for the cost of care for those who cannot pay their bills.

All this, though, is contingent on approval of the Obama administration.

The problem for Arizona is that last year's federal health care law requires states to maintain the Medicaid programs they had the day the president signed the bill or lose all Medicaid funds, about $7 billion a year. Brewer acknowledged there is no guarantee Arizona can get the waiver she is being authorized to seek.

"I'm trying to be optimistic,'' the governor said.


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