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Medicaid debate should remain focused on the merits of expansion

Senate approval of the governor’s Medicaid expansion bill clearly reflects the will of the people.  Senate Majority Leader John McComish led the charge, breaking rank from Republican colleagues who opposed the bill.

And Senator Steve Pierce, who does not exactly qualify as a left-wing radical, not only wholeheartedly supported the initiative but also posted an inspiring article in the May 20 issue of the Arizona Capitol Times.  Elaborating on his rationale for supporting expansion, Pierce states “…I am proud of what my colleagues and I did, by working with our governor, and in a bi-partisan manner, do what is in Arizona’s best interest.  It wasn’t courageous — it was our job! We were elected to do a job, not to keep it…”  Refreshing words, indeed, coming from a politician.

Unfortunately, House Speaker Andy Tobin appears determined to block the measure’s passage in the House.

Despite the fact that voters have approved ballot initiatives calling for Medicaid expansion on two separate occasions, supporters of expansion fear that this time around the public debate would deteriorate into a mean-spirited referendum on Obamacare, financed by out-of-state interests.  We cannot afford to let that happen.  It is imperative that any debate remain focused on the merits of Medicaid expansion as they impact the well-being of Arizonans.

In brief, key benefits that the governor’s proposal promises to deliver include:

An additional 1.6 billion federal dollars will be infused into our Medicaid program at no net cost to Arizona. This will enable an estimated 300,000 needy Arizonans to access quality health care, and thousands of lives will be saved.

The Grand Canyon Institute projects that this funding will bring an additional 21,000 jobs to Arizona — many of which will be in the high-paying health care sector.

The legislation will protect safety net hospitals throughout the state from being pushed to the brink of bankruptcy by growing costs of uncompensated care created by Arizona’s 2010 Medicaid cut-backs.

The initiative’s objective of extending coverage to additional needy Arizonans offers potential to reduce welfare costs, by enabling many of these people to correct medical conditions that jeopardize their ability to obtain gainful employment.

The measure enjoys widespread support from the hospital community, the Arizona Medical Society, and business and community leaders throughout the state.

Unfortunately, zealous opponents of Medicaid expansion appear determined to vote down the measure as a protest against Obamacare, without giving due consideration to how passage of expansion will benefit our state.

Having studied provisions of the Affordable Care Act (commonly known as Obamacare), I admit that the act is far from perfect. However, as a public health professional I firmly believe that the law provides a workable starting point for badly needed health care reform. Positive aspects of the ACA include incentivizing more physicians to practice primary care through raising Medicare reimbursement for these services, providing an expanded array of preventive services for Medicare beneficiaries, prohibiting insurers from denying coverage due to pre-existing conditions, and availing affordable coverage to millions of uninsured Americans.

Again, any and all debate concerning Medicaid expansion must focus on provisions of the various proposals as they affect the well-being of residents of Arizona. It would constitute a gross disservice to allow the debate to deteriorate to a mean-spirited referendum on Obamacare, financed by well-heeled out-of-state interests.

At this juncture, Speaker Tobin’s staunch refusal to allow the House to vote on Medicaid expansion runs an extremely serious risk of “throwing out the baby with the bathwater.”  We cannot afford to let that happen. In the interest of best serving the welfare of his fellow Arizonans, I implore the speaker of the House to withdraw his proposal to bring the measure to public vote, and focus his efforts on negotiating whatever provisions he believes will strengthen the measure’s ability to best serve our people’s interests.

Editor’s note:   Tobin dropped his plan to bring the measure to a public vote on May 28, but two former state senators hope to gather enough signatures to put the plan to voters.

— John Newport is a former senior health services research and policy analyst at the UCLA School of Public Health.

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