IT’S WRONG – AND COSTLY – TO DROP PEOPLE FROM STATE MEDICAID PLANby Barbara Warren, MD, MPH on Jul. 28, 2011, under Uncategorized
By Dr. Eve Shapiro and Dr. Matt Heinz Special To The Arizona Daily Star | Posted: Tuesday, May 24, 2011 12:00 am
A lawsuit has been filed in the Arizona Supreme Court to block Gov. Jan Brewer and the Arizona Health Care Cost Containment System, or AHCCCS, from freezing or dropping patients from our state Medicaid plan.
Why is this step necessary? In 1996, Arizona voters passed Prop. 203 by a significant majority. This measure increased AHCCCS eligibility from 33 percent to 100 percent of the federal poverty level. Currently, the federal poverty level is about $24,000 for a family of four. Arizona voters rightfully agreed that the previous coverage limit was inadequate.
Unfortunately, the Legislature neither implemented this plan nor several other voter measures.
In 1998, the Voter Protection Act was passed, which stated that the Legislature had to implement any voter- passed measure. In 2000, Prop. 204, with the same eligibility level as Prop. 203, was approved by a majority of voters in every county in the state. This measure was partially funded by Tobacco Settlement Funds, partially by state general funds and partially by federal funds that match 2-to-1 what the state pays in Medicaid costs.
Over the next 11 years, Prop. 204 has enabled over 300,000 Arizona citizens to get health insurance and thereby improve access to health care. This group is almost one-third of the total number of patients on AHCCCS, a growing number due to our current poor economic conditions.
This year, in an attempt to balance the state budget, the Legislature and Brewer have decided that they can drop up to 250,000 people from AHCCCS to save $500 million, in blatant disregard of the Prop. 204 legislation.
They claim that they have no choice, but there are always choices. The Arizona Hospital Association has offered the Legislature a plan to assess its income, thereby raising about $200 million.
In addition, capital-gains taxes have brought in more than $180 million more than anticipated.
Also, somehow the money was found to give corporate tax breaks of more than $400 million to attract new business to the state, although having a healthy, well-educated population would seem to be a first step to attracting business.
We suspect that it is not a practical matter about finding funding, but an ideological one. Many legislative members believe that it is not government’s role to help people obtain health insurance.
They don’t seem to understand that this attempt affects us all. A recent study found that dropping Prop. 204 would cost the state 30,000 jobs and $2.5 billion in gross state product.
In addition, people without health insurance will continue to get sick and end up in emergency rooms, affecting access to health care for all of us.
Many of the people losing insurance will suffer from worsening of chronic illnesses and possibly early death.
Rural hospitals, with a significant number of patients on AHCCCS, may be forced to close their doors or limit services, affecting all people living in those areas of the state.
Urban hospitals will become rapidly overwhelmed as they trim their workforces while having to treat sicker patients from many miles away.
Community health centers will struggle under the burden of more patients with no health coverage.
In addition, by giving up federal matching funds, we are turning aside up to $2 billion that goes directly to support AHCCCS payments to hospitals and doctors.
This is a wrong and illegal move. It will now be up to the courts to stop it
Dr. Eve Shapiro is chair of the Prop. 204 Committee. Email her at: email@example.com
Dr. Matt Heinz represents Legislative District 29 in the state House of Representatives. Email him at: firstname.lastname@example.org