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Medicaid progress at risk as cuts to program loom


I’ve been in public service long enough to know there’s a time to play politics and a time to rise above it.

As our elected leaders in Washington chart a new course on health care – and Medicaid coverage for tens of millions of Americans hangs in the balance – consider this a clarion call for statesmanship.

Look, Obamacare has real flaws. There is bipartisan agreement the state health exchanges are broken and, for far too many Arizonans, health insurance remains unaffordable and out of reach.

But in the course of addressing these shortcomings, it makes no sense to cripple a separate health care program with a 50-year track record of success: Medicaid.

First, a little backstory: I was elected to the Arizona Legislature in 2010, during the depths of the Great Recession. More than one-third of Arizona’s General Fund revenue evaporated in the wake of the housing collapse, resulting in a series of tremendously difficult cuts to state programs and services.

One of those decisions was to freeze enrollment in Medicaid for adults without children. Over the course of 18 months, more than 160,000 Arizonans fell off the Medicaid rolls. Some were in the middle of receiving lifesaving treatment. Many others began turning up in hospital emergency rooms as their last and only option to receive medical care.

The personal and economic toll from these Medicaid cuts was immense and heartbreaking.

That’s why, a couple years later, I was proud to stand with then-Gov. Jan Brewer and a bipartisan coalition of legislators as we lifted the enrollment freeze and restored Medicaid coverage for Arizona’s working poor.

Today, it’s clear we made the right decision. The number of Arizonans with health coverage is up; care provided by Arizona hospitals to the uninsured is down 60 percent statewide; and billions of federal dollars – our own tax dollars – are flowing into the local economy.

I now fear all of this progress is at risk. Congress has proposed slashing $880 billion from Medicaid over the next decade. It is simply not realistic for the state of Arizona to make up for this loss of federal funding. If enacted, these Medicaid cuts threaten a return to the bad-old-days of enrollment freezes, increasing numbers of uninsured and growing cost shifts in the form of higher health premiums, not to mention ER waiting rooms clogged with non-emergencies.

No government program is perfect, but Arizona’s Medicaid program – known as AHCCCS – is the gold standard when it comes to delivering quality, affordable health care. Our state’s Medicaid program uses an integrated, managed-care model that promotes competition and patient choice, controls costs and incentivizes preventative care. Gov. Doug Ducey continues to thoughtfully reform the program to ensure it is taxpayer-friendly, most significantly by preparing enrollees for the day they’ll transition off Medicaid and onto private coverage.

I look forward to working with the governor and Washington officials to ensure Medicaid remains viable for the more than 1 in 4 Arizonans who depend upon it.

— Rep. Heather Carter, R-Cave Creek, is chairwoman of the House Health Committee. 


The views expressed in guest commentaries are those of the author and are not the views of the Arizona Capitol Times.


  1. It’s always disturbing to see elected officials who do not understand the limitations placed on government by the people through our Constitutions (state and federal). Some, like Representative Carter, seem to think they can do any damn thing they want without regard for the legality of their positions. The people have not delegated to Washington the authority to regulate, insure, or provide health care and, until we do, federal programs related to those areas are, and remain, extra-constitutional.

  2. As Daniel Webster warned, “Good intentions will always be pleaded for every assumption of authority. It is hardly too strong to say that the Constitution was made to guard the people against the dangers of good intentions. There are men in all ages who mean to govern well, but they mean to govern. They promise to be good masters, but they mean to be masters.”

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