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Legislature sends AHCCCS waiver bill to Brewer

Sen. Kyrsten Sinema (Photo by Evan Wyloge/Arizona Capitol Times)

Sen. Kyrsten Sinema argues Thursday that the proposed AHCCCS waiver would violate a voter initiative passed in 2000. (Photo by Evan Wyloge/Arizona Capitol Times)

The House and Senate ended the first special session of 2011 by approving a bill authorizing Gov. Jan Brewer to ask the federal government for permission to drop 280,000 patients from the state’s Medicaid program.

S1001 passed the Senate on a 21-9 vote and the House by a 40-20 vote on Jan. 20. The party-line votes give it the two-thirds majority it needs to go into effect immediately after Brewer signs it.

Brewer spokesman Paul Senseman said the governor will sign the bill Friday morning and apply for the waiver by Monday.

Brewer’s budget proposal, which she released last week, calls for the state to cut $542 million from AHCCCS to help balance a projected $1.15 billion budget deficit in the fiscal year 2012. But the state needs a waiver from a mandate in the 2010 federal health care law that prohibits states from reducing eligibility for their Medicaid programs.

“I support this bill, not because I am filled with glee, but because we were elected to balance the state budget,” said House Majority Whip Debbie Lesko. “We are down to bad options and worse options. And we were elected to solve the problem.”

Brewer is seeking a two-year waiver, which would allow the state to drastically reduce AHCCCS eligibility until 2013, when the health care law will require all states to provide Medicaid coverage to anyone earning up to 133 percent of the federal poverty level.

Democrats called Brewer’s budget plan “unrealistic.” They said it would take the federal government 10 months to review Arizona’s application for a Medicaid waiver, and said they doubted the federal government would actually approve the request.

Republicans said Arizona has a good case to make before the federal government, considering that large corporations and labor groups were granted a similar waiver. House Majority Leader Andy Tobin said the feds have approved 222 waivers to companies like McDonald’s and labor unions like the Service Employees International Union.

“It amounts to 1.5 million enrollees,” Tobin said. “That’s more than we even have on our AHCCCS program.”

Even if the federal government approves the waiver, lawmakers from both parties said they expected a court battle to determine whether state law bars Arizona from reducing AHCCCS eligibility. Proposition 204, passed by voters in 2000, raised AHCCCS eligibility to 100 percent of the federal poverty level. Because the funding was mandated by voters, proponents say it can’t be cut without violating the voter-protection language in the Arizona Constitution.

Democrats argued that cuts to AHCCCS would violate Proposition 204, while Republicans said the cuts are permitted due to language in the law that says AHCCCS must be funded by revenues from a court settlement with tobacco companies and other “available funds.”

“It is suggested that we are violating the will of the people…but the people never voted to spend one dime of general fund money,” said Rep. John Kavanagh, chairman of the House Appropriations Committee.

Rep. Chad Campbell, the House Minority Leader, countered with a passage from the 2000 publicity pamphlet for Proposition 204, which stated that future legislatures could expand AHCCCS coverage, but could not reduce it.

“It is very clear what the voters intended when the passed his,” Campbell said. “I could read more and more about this. But we’re going to let this get decided in a court, I think, which has become our tradition here in Arizona.”

The bill passed with an emergency clause after beating back an attempt by Senate Democrats to raise the vote threshold.

The bill, which contains an emergency clause, needed two-thirds of the Legislature to pass. But Sen. Kyrsten Sinema, a Democrat from Phoenix, wanted to raise the vote requirement to a three-fourths majority. House Democrats made a similar push in the House Rules Committee earlier in the day.

Sinema said her amendment would have put the state in a better position against lawsuits challenging its constitutionality.

“I was asking them to follow the constitution,” Sinema said.


  1. I sincerely hope that none of the people who voted to take away medical benefits from the poor…. the poor who VOTE and pay taxes… never ever find themselves in need. Two years is a really long time to be denied access to health care in a way that will drive one’s level of poverty even further into the ground than it already is. Without AHCCCS, people like me will have no choice for health care other than emergency rooms, and we already cannot afford that. And before anyone gets it in their head to tell me to get a job: trust me, I am trying to do that. Not a day goes by that I am not sending out resumes and making calls trying to find work. I don’t use or sell drugs, I don’t drink alcohol or smoke tobacco, and I volunteer in my community to help those in need like myself. All I need is a little help until I get back on my feet. I have been working and paying taxes for a long time, and I think that I deserve the help that I paid for already. I am not trying to leach off the system, I am trying to get some help so I can back into the workforce and help build up the system. Give us a break here!

  2. Why don’t you take a pay cut Brewer and get rid of more state workers and politicians here that we don’t need? They only steal from the till anyway. Cut services to all non-American citizens, get them out of the state. You have gone too far.

  3. What I have been unable to find so far anywhere are specifics about exactly how they will decide who gets cut off from ahcccs. Is it all childless adults? Is it all childless adults who are not on social security disability? Or is it all childless adults who make more than one third of the poverty level? Some specifics would be nice to know, so I can plan accordingly.

  4. This goes beyond the needs of basic, routine medical care… For people like myself (CML) and my son (Epilepsy) what are we to do, when in reality, we are poverty level and cannot afford this chronic treatment alone. I work and pay taxes, but in this economy with preexisting med conditions where are we to get insurance we can afford. Blue Cross/ Blue Shield was cancelled a long time ago… Point being, forget myself, but I refuse to sit and watch my son die from a deadly condition. I would lose everything just to keep him healthy and I still have two other kids to worry about… I pray that they at the least make exceptions for those with chronic illnesses, even if just minors… So Sad

  5. I spent the most embarrassing and humiliating 3 hours of my entire life at my local DES office today, only to be told that I was basically going to get squat because I don’t have kids. I don’t begrudge any parent who cannot afford to adequately take care of their families, but I pay taxes too. Why am I less worthy of the assistance just because I don’t have any children? I am just as likely to lose my home and my car, which will make it even more difficult for me to find a job. I think children need to be cared for – there is no question about that, but I need help too. Our country is doing a LOUSY job of caring for its people. You know, maybe less state dinners and big lavish parties and trips to all parts of the world for what seems like nothing other than a site seeing trip. I see all these big conventions and meetings on TV for both state and federal government…. yet I don’t see anyone brown bagging it. I see big, lavishly catered meals. I am all for tightening the belt, but the working poor, and the unemployed shouldn’t be the only one’s doing it. Sorry, but most of us have our belts so tight we can’t breathe anymore.

  6. Carolyn Sue Barker

    I am one of those on Social Security disability for none other than 7 Chronic diseases: diabetes, atrial flutter and congestive heart failure, Chronic anemia, psoriasis, psoriatic arthritis, and fourth stage kidney failure. My medications alone cost about 25,000 a year and I live in assisted living paying most of my social security for that with Arizona Long Term Care paying the rest. If they terminate Arizona long term care I will die.

  7. Just thank all of those AHCCCS recipients who keep their hours at work just below the cut-off point where they will lose their benefits! I know at least 3 people who turn down hours at work because they will lose their health insurance and food stamps!! They always have 3 day weekends and don’t have any financial stress… they are comfortable being in the financial lower class!! I wish there was some anonymous hot-line that you could report these people to!! I even know one person who claims to be disabled with OCD and anxiety… but then spends every weekend camping and hiking with friends… even travels across the country to visit their family… who gives her $$ “under the table” so she doesn’t loose her benefits!! These people should be forced to stand in front of all of the hard working Americans and see what reaction they get!

  8. What are the people that have no children and like others have said have life saving issues have no insurance . What are we to do. Unless they want to let people die. This great thing that we are getting jobs but we need jobs now and then hopefully the company has a insurance plan. Need to get the Dr’s and hospita’sto stop over charging for care.

  9. My husband and i have 3 kids all of us are on accchs and my husband is disabled but ssd wont admit it he has epilelpsy (sorry for the spelling) my oldest daughter has neualogical problems and my youngest daughter has a form of autism and a heart mumer. I have a job that at the moment im employed but not recieving any hour and looking for a job if our health care is taken from us we will not be able to survive. this is sad that it is coming down to this.

  10. I am on AZ accchs not by choice either but becasue of medical mental issues, i’ve applied for Social Security disability and denied twice and I have papers agreeing that I should not work with the plubic and yet, you support those people in jail, fed them and give them free acchs, instead of taking from the poor, why on earth dont you cut your pay checks, get rid of ppl in jail n do smoethign for the PPL that voted for you instead of denying us whats fair.. You wanna save money, live in a cheap apartment with every one else in their suits after all, we’re the fools that beilved you when we voted.. what a joke, so i’m gonna worry myself sick if I’m going to be denied and can’t afford my mental meds???

  11. This governor had lost her mind and we the people sit back and do nothing, I sure hope she is not voting back into office. That’s a start VOTE HER OUT, ASAP. But like it was said, if they take cuts in pay and live like the rest if us then there would be money instead of taking it from those who barely have anything.

  12. I am 60 years old, have a severe hearing impairment, a history of depression, anxiety and PTSD. I was dropped from AHCCCS because I am single and have no children. Since that time I have had no access to mental or medical health care. I have a physical disability due to a past serious injury to my right leg. I cannot walk more than one block, cannot use the bus…even if I had the money for a bus pass. I cannot work full time. I am for all intents and purposes indigent. They can’t get blood from this turnip! I need continued mental health care to maintain some ability to function on a daily basis. I need medical health care for blood pressure and cholesterol. It feels like I have been given a death sentence! I will not vote for anyone who will strip me of a fighting chance to have a productive life!

  13. Since being dropped from AHCCCS because I am single and have no children I have not had access to the mental health and medical health care that I need to be more functional on a daily basis. GIVE ME A FIGHTING CHANCE!

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