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Medicaid director should champion patients

John Newport

John Newport

Maricopa County Superior Court Judge Katherine Cooper has rejected arguments by Tom Betlach, director of the Arizona Health Care Cost Containment System – Arizona’s Medicaid program – that he can effectively protect our state’s expanded Medicaid program by serving as sole defender in a lawsuit filed by the Goldwater Institute.  This litigation seeks to derail the Medicaid expansion sponsored by Gov. Jan Brewer and approved by the state Legislature and signed into law in 2013.

Attorney Tim Hogan, of the Arizona Center for Law in the Public Interest, speaking on behalf of a group of recipients who were added to the Medicaid rolls as a result of the expansion, argues that the center should actively participate in the defense as these recipients will lose their Medicaid coverage if the plaintiffs prevail.  Indeed the stakes are high, as an estimated 320,000 needy Arizonans will lose their coverage if the Goldwater Institute prevails.

Judge Cooper, in a statement concurring with Hogan’s stance, states that these Medicaid recipients “have a direct interest” in the lawsuit’s outcome as funding for their health care is at stake.  In accepting Hogan’s arguments, she concurs that “their (the recipients’) interests may not adequately be represented” by the AHCCCS director.

Hogan’s concerns relate to drastic changes in the political landscape that potentially place Betlach in an awkward position.  When he championed the expansion program during deliberations in the state Legislature he reported to Gov Brewer, who was a vociferous supporter of the program.  Now he reports to Gov. Doug Ducey, whose stance on the program represents a radical departure from his predecessor’s.  As Hogan points out, while campaigning for the governor’s spot Ducey actively opposed Medicaid expansion.  Furthermore, as governor he has appointed Christina Corleri, a former Goldwater Institute staffer who actively opposed Medicaid expansion, as a health-care adviser.

Alluding to possible divided loyalties on Betlach’s part in serving as sole defendant in support of the Medicaid expansion, Judge Cooper notes that Betlach is in the position of “defending an action taken by his former employer” that may not be equally shared by his current boss.

Regardless of the shifting political landscape, I believe that Betlach, in his capacity of director of our state’s Medicaid program, has a moral – if not a legal obligation – to both protect and defend the interests of the beneficiaries, who rely on the program for access to needed health care.  As such he should support the Arizona Center for Law in the Public Interest in their rallying to the cause to preserve our state’s hard-won Medicaid Expansion program.

We are truly dealing with a life and death matter here.  As such, Betlach should take a strong stand as an unequivocal champion of our Medicaid beneficiaries, even as our newly-elected governor continues to play out his apparent penchant for self-destruction.

– John Newport is an author specializing in health care reform and a former senior health services research and policy analyst at the UCLA School of Public Health.

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