Republicans eye cuts to AHCCCS - East Valley Tribune: East Valley Local News

Republicans eye cuts to AHCCCS

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Posted: Monday, March 1, 2010 7:36 pm | Updated: 3:31 am, Sat Oct 8, 2011.

Republican legislative leaders are planning what could be an end run around voters to scale back the state's program of free health care. A budget plan being crafted would deny free care to nearly one out of every four people now enrolled in the Arizona Health Care Cost Containment System. That comes out to about 310,000.

Lawmakers and even Gov. Jan Brewer have been discussing that concept for months. What's new is that lawmakers don't intend to ask voters to approve the cutbacks, even though they were the ones who approved the expanded plan a decade ago.

Rep. John Kavanagh, R-Fountain Hills, said he doesn't believe voter OK is necessary, given the way he reads the language of that 2000 initiative.

But Senate Minority Leader Jorge Garcia, D-Tucson, said he doesn't read the 2000 initiative that way. He said it requires lawmakers to come up with whatever cash is available to provide free care to all those below the federal poverty level.

And if they want out, Garcia said, they have to ask permission from voters. Otherwise, he said, the state is going to end up in court.

Kavanagh conceded the possibility but said he believes the plan is legally sound.

Prior to 2000, the state provided free care to those who met certain income standards. With certain exceptions, eligibility for the program, funded by federal and state dollars, was about one-third of the federal poverty level.

Proposition 204 expanded that to the poverty level, now $18,310 for a family of three.

According to that initiative, the expansion would be paid for by the state's share of a nationwide settlement with tobacco companies. Arizona now gets about $118 million a year.

But the state's share of AHCCCS now is more than $1.1 billion a year.

Brewer, in her budget plan, said Arizona can't afford to have more than 1.2 million people - about one out of every six Arizonans - getting their care from the public. She proposed taking the question back to voters.

Kavanagh, however, said that's not necessary.

He is relying on a section of the initiative that says the expansion is funded by tobacco dollars "and shall be supplemented, as necessary, by any other available sources including legislative appropriations and federal monies."

"As of now, there are no other available sources," Kavanagh said.

"We're broke," he continued. "We're $3 billion in the hole."

He said lawmakers would scale back eligibility to what it would be with just the tobacco dollars. What that figure is in terms of income, though, remains unclear.

Garcia said the state is just courting an unnecessary lawsuit.

"The attorneys are going to have a heyday with this," he said. He predicted that if lawmakers approve the change, a judge will block it from taking effect.

Kavanagh acknowledged there is other money "available." But he said the measure voters approved in 2000 does not require lawmakers to spend anything beyond those tobacco dollars on health care.

He said the measure was sold to voters on the basis the tobacco dollars would cover the entire extra cash. "This was a very deceptive ballot measure," Kavanagh said.

The record, however, is less clear.

There actually were two measures on the 2000 ballot.

One would have limited expansion of AHCCCS to only the tobacco funds available. The second - the one that became law because it got more votes - had the language saying those tobacco dollars "shall be supplemented" to cover everyone below the federal poverty level.

Kavanagh said that isn't a blank check.

"I don't think the voters intended to give this program priority over every other program, including having police on the streets and keeping prisoners in prison," he said.

But Garcia said that cutting other programs isn't the only option.

He said the state can raise taxes to fund its obligations. And this, he said, is one of those obligations.

Kavanagh said one reason not to send the issue to voters is timing.

"We need the money now," he said. Trimming eligibility could take place the moment the measure becomes law - assuming a court does not intercede; taking it to the ballot means waiting until at least November, along with the chance voters might not approve.

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