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home : latest news : latest news September 15, 2014

8/3/2012 9:56:00 PM
January is target for Brewer decision on Medicaid

PHOENIX (AP) - Gov. Jan Brewer apparently won't say until January whether Arizona should expand the state's Medicaid program under the federal health care overhaul - a decision that could present legislators with a white-hot political issue.

That's the word from Brewer administration officials who briefed reporters on Thursday about funding and policy considerations being weighed by the governor, her staff and agency officials.

Officials in Arizona and other states are waiting for federal officials to answer numerous questions about states' options regarding the Medicaid expansion, and Brewer administration officials said her policy choice would be part of the budget proposal she submits to the Legislature at the start of 2013 session in January.

"It becomes part of what's available in terms of resources in the budget discussion," said Tom Betlach, director of the state's Medicaid program and a former state budget director.

Though Brewer could propose a course for the state to take on the Medicaid expansion, the Legislature also would have a big say on the issue because expanding the program would require additional state funding along with possible changes in state laws.

The health care overhaul included requiring states to expand their Medicaid programs to make more low-income people eligible. But the Supreme Court's June decision upholding most of the overhaul overturned the provision making the Medicaid expansion mandatory for states.

While some Republican governors have already taken firm stands against implementing the Medicaid expansion or any other part of the overhaul, Brewer is taking a more deliberate approach for now as her state and others press federal officials for more information on implementation and funding.

Many majority Republicans in Arizona also have staked out firm positions against implementing any part of the overhaul, while Democrats are pressing for full implementation. Hospitals also want the state to go at least part way so they can get compensated for more care that they must provide regardless of patients' ability to pay.

A key question for Brewer's administration is whether Arizona would get additional federal dollars provided by the overhaul even if it implements only part of the Medicaid eligibility expansion. One possible option for the state is to only increase its program to the eligibility levels previously in place before the state implemented a partial enrollment freeze and made cutbacks due to budget troubles that have eased since then, officials said.

State officials think their federal counterparts have discretion under the health care law to provide the extra funding even if a state doesn't go the full-expansion route, said Monica Coury, a deputy to Betlach. "It's a policy decision for them."

While Brewer is not expected to tip her hand on the Medicaid expansion issue until January, the state must by mid-November tell Washington its choice on another health care overhaul issue.

That's whether Arizona will create and run a so-called "exchange" - an online marketplace for health care coverage - or let the federal government provide that service.

There's also an option of having a hybrid "partnership" arrangement, but there will be an exchange no matter what because it is mandated by the overhaul and the only question is who designs and runs it, said Don Hughes, Brewer's health policy adviser.

Hughes said Brewer hasn't made a decision on the exchange issue but he said she wants to impose as few regulations and reporting requirements on insurers as possible "and not turn the exchange into a second de-facto regulator of the insurance industry," Hughes said.

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Reader Comments

Posted: Sunday, August 05, 2012
Article comment by: A Compassionate Arizonan

The problem with Mr. Steele's idea of kicking out from the Emergency Romm those who are not truly suffereing an "Emergency", is that these are the people who can't or won't pay for medical care. No doubt about it, treating seemingly minor ailments in an ER is the worst possible way to treat them with the exception of NOT treating them. Not always, but sometimes those minor ailments turn out to be contagious diseases, and left untreated they can be spread by that carrier who probably has no choice but to go to work sick and now we have to possibility of an epidemic.

The answers aren't always easy. Sometimes the answers are expensive. Let's at least get the biggest bang for our buck. Not treating someone at the ER could become more expensive than treating them.

Posted: Saturday, August 04, 2012
Article comment by: Anyone know total $ to pay malpractice claims?

This is a small community. I haven't heard of any big ambulance chasing court cases. Sounds like an insurance company Boogey Man, but I'd change my mind if someone could point me to facts that say how much is spent on paying claims that shows it's a bigger issue than 10% sales commissions for insurance agents selling annuities.

Posted: Saturday, August 04, 2012
Article comment by: sic of gov. telling me what to do regarding my hea larsen

cant get shingles shot with medicaid....but no problem with $500.00 in medicine for shingles in the last six months.....and two office visits.....oh well blame the people like me on social security for the expense.......we worked for 26 years.......its all screwed up thanks jan

Posted: Saturday, August 04, 2012
Article comment by: Elizabeth May

Dear Judy,
I am confident that you will find help for your grandaughter at the well women's clinic but if you ever hit a dead end, call me at 928-713-9163. I will help.

Posted: Saturday, August 04, 2012
Article comment by: Voting for Tom Steele

And that's why I wrote-in Tom Steele for every unopposed race/position on this year's ballot (except for Pam Pearsall who's kicking @$$ as she should.)

Posted: Saturday, August 04, 2012
Article comment by: M D

@ Steele. Your suggestion that tort reform is an answer has been proven incorrect by Texas. Texas passed medical tort reform in 2003 and while malpractice premiums have been reduced by 27%, insurance premiums have continued to rise faster than the national average and Texas is one of the states that has the highest number of uninsured. Clearly the Texas plan is not a solution. Romney has not stated that he will eliminate the law, passed under Reagan, that requires ER's to treat the uninsured, nor should he. Judy's situation is one of the reasons that retaining Obamacare is so important. Health insurers will no longer be able to rescind coverage if you get seriously ill. Insurers will no longer be able to cite prexisting conditions as a reason to deny coverage to a sick newborn indeed prexisting conditions clauses will be eliminated for everyone. No longer will you lose coverage if you reach a dollar limit, not uncommon if you are battling cancer. Soon , if you lose your job, due to outsourcing or any other reason, you won't lose your access to healthcare. Romney has promised to eliminate all these provisions by repealing the act. This in spite of the fact that the nonpartisan Congressional Budget Office has recently reported that repealing Obamacare will add $109 billion to the deficit in the next 10 years.

Posted: Saturday, August 04, 2012
Article comment by: Pat O'Brien

Wrong again Tom. You stated that emergency room care regardless of the ability to pay was mandated by presidential order. This was the second time you stated this in a article comment. It was a law passed by Congress and signed by President Reagan. Also, hospitals are not required to provide all care through the emergency room. The rest of your comment makes no sense. And no one can reduce medical costs overnight. Fixing health care will take time. Just like improving the typical American's physical condition and health habits will take time. They are linked.

Posted: Saturday, August 04, 2012
Article comment by: Elizabeth May

I'm sorry. I meant to say grandaughter.

Posted: Saturday, August 04, 2012
Article comment by: Elizabeth May

Dear Judy,
I'm very sorry to hear that your daughter needs chemo. My suggestion is to call the County Health Department for directions, then take your daughter to the Women's Wellness Clinic, along with her letter that she is denied AHCCCS. They have special programs to qualify women for cancer treatment through Medicaid. A really good friend of mine was able to get Medicaid coverage for her cancer treatments by doing exactly that this past year.

Posted: Saturday, August 04, 2012
Article comment by: Judy Contreras

Our 19 year old grandaughter recently found out she needs chemo treatments. Ins droped she tried access they say no children, cant help. Medicade says no children cant help. Please tell us what can a 7th or more generation American citizen do? Our children HAD dreams to. If anyone has an answer or can tell us what we are to do please let me know, and keep her and millions of other American children in our prayers, thank you.

Posted: Saturday, August 04, 2012
Article comment by: Tom Steele

President Romney will also want to relieve hospitals from the burden of providing all care through the emergency room. This old presidential order must be removed and only "real" emergency's be treated. Obama care does nothing to reduce costs as promised. Some 31 new taxes and no relief for medical personnel from ambulance chasing lawyers makes the law expensive. Hopefully, the Romney administration will have a plan for health care outlined for a "rational" approach to the many facets of health care.

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