At a press conference Wednesday at the Maricopa Medical Center, Brewer stood with nearly a dozen representatives from business organizations and health care groups who threw their support behind the governor’s plan to expand Arizona Health Care Cost Containment System coverage to include anyone earning up to 133 percent of the federal poverty level. The health care and business leaders said Brewer’s plan to expand Medicaid coverage under the Affordable Care Act will stimulate the state’s economy and ease the burden of the “hidden health care tax” that businesses and individuals face due to uncompensated care for uninsured Arizonans.
“They know the impact that $8 billion from the federal government over three years can have on the Arizona economy. They know this will save and create many thousands of jobs in the community across our state. Likewise, our hospital presidents and CEOs understand the growing costs they face in providing care for the uninsured,” Brewer said. “These costs are real, and they are not just absorbed into the hospitals’ bottom lines. No. ultimately much of this cost is passed along to Arizona families.”
Maricopa Integrated Health System CEO Betsey Bayless said the county’s public health care system saw uncompensated care jump from 13 percent to 26 percent of its total care from 2010 to 2012.
“Moving forward with Medicaid expansion means Arizona health care institutions will not be forced to make severe cuts that harm our patients, their families and our economy,” Bayless said.
Glenn Hamer, president and CEO of the Arizona Chamber of Commerce, said the impact of uncompensated care extends beyond the health care providers themselves.
“Uncompensated care is eventually borne by health care consumers, including businesses that purchase commercial health plans as costs rise to make up for the shortfall that results from caring for the uninsured,” Hamer said.
And Judy Rich, president and CEO of Tucson Medical Center, said uncompensated care tripled over the past 18 months for her organization.
“Expanding AHCCCS will allow the state to better manage this vulnerable population, getting these individuals into the right level of care, in the right setting, at the right cost,” she said.
While business and health care leaders stood behind the governor, no legislators were on hand to voice their support. Brewer has been vague about how she will get Republican lawmakers to support her plan. But she said she believes the support will be there.
“From the time that I delivered my message on Monday, I have talked to several legislators and I have traveled to Tucson, and I am going to continue traveling the rest of this week to other places and next week. But the response from elected officials and the public after they understand what we are doing and how it’s affecting Arizona, the support has been very, very encouraging,” Brewer said.
Brewer’s plan appears tailor-made to blunt legislative opposition, especially from GOP lawmakers who are hesitant to increase spending or do anything to comply with President Obama’s signature health care law. The state’s share of the additional Medicaid coverage would be covered by an assessment on hospitals, essentially a tax on health care providers. It would include a “circuit breaker” provision to eliminate the increased coverage if federal matching funds drop. And it aims to prevent health care providers from passing the cost of the assessment on to consumers.
The governor said she believes all hospitals, even those that don’t provide much uncompensated care, support her plan.
“But I can tell you that we have reached out to every institution, every hospital. They understand the issue. And I believe that everyone providing those kinds of services are on board with what we’re intending to do,” Brewer said. “We understand that there are some hospitals that are not serving that population and I think that those details will be worked out in the very near future. That doesn’t mean that they’re not on board with the idea of what we’re doing.”
Brewer was short on details of her plan, many of which she said have yet to be worked out. The Governor’s Office plans to release some details on Friday.
AHCCCS Director Tom Betlach said the assessment is expected to bring in about $220 million per year. Under the Affordable Care Act, the federal government will provide 85 percent of the cost of expanding Arizona’s Medicaid program.
At least one opponent of Brewer’s plan was in attendance. Tom Jenney, the director of the Arizona chapter of the conservative Americans for Prosperity, said he hopes to convince conservative lawmakers to oppose the plan, and suggested that Brewer herself could even be persuaded to change her mind. He said the hidden health care tax argument is “largely bogus.”
Jenney said proponents of Medicaid expansion have inflated the costs incurred due to uncompensated care, and said providing government-run health care to the uninsured won’t help control health care costs.
“We’re hoping, with more information and with some pushback from legislators and from grassroots activists like us, we’re hoping that she will change her mind,” Jenney said.