Gov. Jan Brewer is considering freezing Medicaid enrollment as early as April 1 for childless adults as part of a phase-out preparation for kicking 250,000 people off of the Arizona Health Care Cost Containment System.
If the state wants to cut the quarter million childless adults from AHCCCS, it must submit a phase-out plan to the U.S. Centers for Medicare and Medicaid Services by March 31.
In a Feb. 15 letter to Brewer, U.S. Health and Human Services Secretary Kathleen Sebelius said Arizona would be able to cut 250,000 people from AHCCCS by allowing its demonstration waiver – the agreement under which the state and the feds jointly pay for patients added by Proposition 204 – to expire on Sept. 30. Arizona’s current demonstration waiver lists “enrollment limitation during demonstration phase-out” as a requirement of the agreement.
Voters in 2000 approved Proposition 204, which gave Arizona one of the most extensive Medicaid programs in the country by expanding AHCCCS coverage to include all childless adults who earn up to 100 percent of the federal poverty level.
Legislative Democrats, who oppose the proposed cuts, decried the proposed freeze as unconstitutional under Prop. 204, and threatened a lawsuit if the freeze is implemented. Advocacy groups already are threatening a lawsuit over the AHCCCS cuts included in Brewer’s budget proposal.
“If she chooses to move forward with freezing AHCCCS enrollment on April 1 as she is considering, we will sue and we will stop her from doing this,” Sen. Kyrsten Sinema, D-Phoenix, said at a Wednesday press briefing.
Attorney Tim Hogan, of the Arizona Center for Law in the Public Interest, said he believes the enrollment freeze would violate Prop. 204. Any legal action against the freeze, he said, would likely be part of the same lawsuit his organization is planning against the proposed cuts. He said his organization would likely file suit if the Legislature approves the cuts.
“If there’s some prospect that people not going to be able to enroll … that violates the Voter Protection Act as much as the proposed cuts,” Hogan said.
At their press briefing, legislative Democrats railed against the cuts. Sen. Paula Aboud, D-Tucson, said Brewer’s health care plan for the poor is “Don’t get sick,” while Sen. Linda Lopez referred to the state as a “heath care wasteland.”
Brewer spokesman Matthew Benson would not confirm that the governor is planning to freeze enrollment for childless adults. He said only that “The administration is still in the process of finalizing a plan to modernize Arizona’s Medicaid program.”
“That plan will be made public as soon as it is complete and ready for submittal,” Benson said in an e-mail to the Arizona Capitol Times.
Brewer said she plans to cut $541 million from the fiscal year 2012 budget by dropping the patients. AHCCCS spokeswoman Monica Coury said the freeze would be required if the governor decides to move forward on the cuts and allow the demonstration waiver to lapse, but the agency and the governor have not made any final decisions on the issue.
Following a Monday meeting between Brewer and Sebelius, Benson said the governor is hoping the feds allow Arizona to add fees, make cuts and carry out other efficiencies that would prevent some of the 250,000 people from being cut.
The Arizona Hospital and Health Care Association is also working on a provider-tax proposal that would help offset some of the cuts and is cooperating with other health care industry groups on the issue.
However, in a Feb. 24 e-mail to Tim Schmaltz of Protecting Arizona’s Family Coalition, a pro-social services advocacy organization, Coury said that the hospital association doesn’t appear committed to the proposal.
“To date, the hospitals have not come forward with any concrete viable proposal, so we remain unclear as to their willingness to participate in a hospital provider assessment,” she wrote.
Coury later said she thought the hospital association was sincere about the provider-tax proposal.