Our state Legislature will soon decide whether to provide 434,855 uninsured adults with basic health care coverage. Some of those folks live right here in Green Valley, Continental and Sahuarita.
The Affordable Care Act (ACA or Obamacare) offers federal funding to states that opt to expand eligibility for Medicaid to include adults under the age of 65 who earn less than $15,282 per year ($31,22 for a family of four). That’s 133 percent of the federal poverty level.
Gov. Brewer proposed her plan for Medicaid (AHCCCS) expansion last month and is trying to drum up legislative support. Calling her plan the conservative model for Medicaid, she proposes that the state fund its portion ($1.5 billion) of the expansion cost with an assessment on hospitals. In return, the federal government will provide Arizona with about $8 billion.
Not only does her plan come at no cost to the state General Fund, it will include a financial failsafe provision that terminates the expansion if the federal reimbursement rate falls below the rate anticipated.
Supporters of her plan include the chambers of commerce of Phoenix and Flagstaff, the Arizona Chamber of Commerce and Industry, the Arizona Small Business Association, Tucson Medical Center, the University of Arizona Health Network, Phoenix Children’s Medical Group, the Northern Arizona Regional Behavioral Health Authority and Vanguard Health Systems.
How will legislators decide whether to support the governor’s plan? Will they consider the financial cost? The human cost? The political cost? The moral cost? Will they consider the corresponding benefits? Will they consider that hospitals routinely bill uninsured patients according to their “list price” schedule, the Chargemaster, while insured patients are billed at a fraction of those rates?
Because voting along party lines has become the norm in the Arizona Legislature, I thought I could find some clues by looking at statements from the major political parties.
From the Pima County GOP
Last month, the Pima County GOP passed a resolution in opposition to the governor’s plan. The resolution’s “whereas” clauses provide a handy list of their reasons for opposition including:
•The hospital assessment is just a tax in disguise designed to avoid the legislative super-majority barrier for all new taxes
•The ACA will bankrupt the nation and the Medicaid expansion will bankrupt Arizona
•All states should reject expansion because that’s “the fastest and most efficient means to end Obamacare”
•There “is no such thing as a conservative model for expanding Socialism” even if it brings in “a short term gift of federal funds”
From the Pima County Democrats
The Pima County Democrats issued a press release that applauded the governor’s plan because:
•Brewer’s plan is “a fiscally responsible, morally just plan that expands coverage for low-income, hard-working Arizonans”
•The high level of uncompensated hospital care created by legislatively imposed reductions to AHCCCS (Medicaid) will be mitigated;
•The federal government’s payment of about $8 billion over 4 years amounts to a very nice rate of return on the state’s investment of $1.5 billion
•21,000 jobs will be created.
From a nonpartisan think tank
Last month, the board of directors of the Grand Canyon Institute, 12 former lawmakers, economists, community leaders and academicians (seven Republicans, four Democrats and one independent), released a study that concludes that the ACA Medicaid expansion is the best option for Arizona’s Medicaid program. They say the expansion will result in the following:
•Cumulative cost to the state General Fund 2014-2017: $1,520,422,753; (the study did not reflect the governor’s plan to zero this out)
•Cumulative inflow of federal dollars 2014-2017: $7,932,760,353
•Additional lives covered and enrolled by 2017: 434,855
•21,000 new jobs
•$2.776 billion in economic growth.
Now it’s your turn
Tell our legislators how you think they should decide.
Maddy Urken lives in Sahuarita. She is a retired information manager and former high school chemistry teacher. You can reach her at email@example.com. If you would like to comment on this column in print, send an email to: firstname.lastname@example.org.