Arizona delegation urges Flake, McCain to maintain Medicaid

A Republican state senator and representatives from business and health care groups are urged GOP Sens. John McCain and Jeff Flake on Tuesday not to back cuts to Medicaid as part of a health care overhaul bill.

State Sen. Kate Brophy McGee, R-Phoenix, said the group met with the senators separately in Washington. The focus was on a part of the House-passed health care legislation that would phase out expanded Medicaid over several years.

Medicaid expansion was a key part of former President Barack Obama’s health care law, and Arizona was one of the Republican-led states that decided to embrace the change. About 400,000 Arizonans have gained insurance under the plan, and a report by the state’s Medicaid agency shows the House bill would cost about 380,000 of those people their coverage and cut health spending by $2.5 billion.

Brophy McGee said the meetings were meant to highlight the cost to the state if the Senate takes up a similar proposal. She said the group told the senators that they should not damage a Medicaid system that is working for Arizona in order to fix the private insurance exchanges that have been the most problematic part of former President Barack Obama’s health care law.

“There are many issues around the legislation, or any proposed legislation or fixes, but we were there expressly to protect our Medicaid program, which is working and working very well,” Brophy McGee said. Gov. Doug Ducey’s aides have also been regularly contacting Flake and McCain about Medicaid.

Opponents of the expanded Medicaid plan call it an unsustainable entitlement program.

Senate Majority Leader Mitch McConnell is leading a group that is writing a Senate version of a bill to replace the Affordable Care Act. Few details have emerged, but a final version could be made public as early as Thursday and McConnell could schedule a vote next week.

Neither Flake nor McCain have taken a position on a Senate bill because its details haven’t been released.

Flake, though, said in an interview late last month that he’ll be looking at whether a Senate proposal allows states that expanded Medicaid enough time to transition while limiting growth in spending on the plan. The expansion covers people earning up to 138 percent of the federal poverty line, or $19,127 for an individual or $39,040 for a family of four.

“As far as what we need, my test will be, one, are we pulling the rug out from under people who don’t have anywhere else to go,” Flake said.

A representative of the association representing hospitals and other providers also attended the meetings with the senators, urging them to maintain the expanded coverage offered by the state’s Medicaid agency, the Arizona Health Care Cost Care Containment System, known as AHCCCS.

“We’re pushing for legislation that protects Arizona — AHCCCS does a really good job relative to other states,” said Greg Ensell, vice president of government relations for the Arizona Hospital and Healthcare Association. “Some of the complaints that are made in Congress truly don’t apply in Arizona.”

Brophy McGee was one of a handful of Republicans who backed the expansion pushed through in 2013 by former Gov. Jan Brewer over opposition from many in her own Republican party. About 1.9 million Arizonans are now covered by Medicaid.

Of those, the expansion population includes about 317,000 childless adults who earn less than the federal poverty limit, and 82,000 earning between 100 percent and 138 percent of the limit. Few if any could afford to buy private health insurance.

Arizona covered childless adults under an optional program that was frozen when the Great Recession hit. The number covered rapidly sank and uncompensated care at hospitals skyrocketed by 61 percent, Ensell said, straining their finances.

“If the expansion population is rolled back, we would expect that same thing to happen – that being a large increase in uncompensated care,’ he said. “As it turns out, people get sick and come to the hospital whether or not they’re on ACHHHS.”