More than 140,000 of the state’s long-term unemployed could eventually find themselves without health insurance.
The state House on Thursday gave final approval to legislation designed to pave the way for a five-year lifetime limit on Medicaid benefits. HB 2367 also would require those who are still eligible to be employed, looking for work or in a job-training program.
There’s a catch of sorts, though: Federal Medicaid regulations currently do not allow such limits.
But the U.S. Department of Health and Human Services, which funds the majority of Medicaid costs, does allow states to seek waivers to find more cost-effective ways of providing care. This legislation requires state officials to seek those waivers, not just this year but every year from now on.
The measure, which now goes to the governor, was crafted by House Speaker Andy Tobin, R-Paulden.
Tobin was a foe of the decision by Gov. Jan Brewer to take advantage of the federal Affordable Care Act which allows states to expand eligibility for their Medicaid programs to those up to 138 percent of the federal poverty level. That is $26,951 for a family of three.
Brewer prevailed, over the objections of Tobin and most Republicans.
So Tobin, who also is running for Congress, said his legislation would help control future costs.
Tobin said while the federal government is picking up virtually all the costs of the expansion from current limits of the federal poverty level, that won’t last forever. And that, he said, means the state needs to start looking now for ways to trim the price tag.
Tobin’s legislation does have exceptions from that five-year lifetime limit. That includes if the person is pregnant or the sole caregiver for a family member younger than 5.
He also agreed to waive that five-year limit if someone remains employed full-time but in a low-wage job — one where the earnings still qualify the person for Medicaid benefits.
Legislative budget analysts figure there are about 212,700 current able-bodied adults who already have been getting care through Medicaid for more than five years. Even after deducting 40,000 who are working full time and 31,700 sole caregivers, that leaves 141,000 who would lose coverage under that lifetime limit.
Separate from the lifetime limit, there is the requirement for Medicaid recipients to be working, seeking employment or in a job-training program. But here, too, the legislation says that mandate does not apply if the person is sole caregiver for a child no older than 4, or if the recipient is getting long-term disability benefits.
Legislative budget staffers said they do not know how many people would lose their benefits under this provision.
Tobin’s legislation also requires state Medicaid officials to try to get federal permission to impose “meaningful copyaments” to deter the use of hospital emergency rooms for nonemergency medical conditions and the use of ambulance services where it is not medically necessary.
Rep. Eric Meyer, D-Paradise Valley, said he is concerned about the effects on some people if the state somehow gets the waiver requests approved.
“This freezes out the poorest of the poor from health care coverage, ” he said. “Those in our state who are unfortunate enough to not be able to find work for whatever reason will now also lose their health care coverage and have nowhere to turn other than an emergency department, or not getting care at all.”