The requirement calls for people receiving health care through the Arizona Health Care Cost Containment System to be working, looking for work, training for employment or going to school in order to get benefits.

With no immediate congressional action in sight, state Medicaid officials are preparing to implement a contingency plan to ensure that nearly 24,000 children of Arizona working poor do not lose their health care coverage this coming month.

Arizona chiropractors will push for the state’s Medicaid program to cover chiropractic care in the next legislative session, the industry’s lobbyist said. And the extension of Arizona Health Care Cost Containment System coverage to chiropractors ties into efforts to combat the opioid crisis, the Arizona Association for Chiropractic claims.

The fate of health care for 400,000 Arizonans could depend on what seven justices of the state Supreme Court believe voters said they wanted 25 years ago.

The federal budget year expired Sept. 30 without lawmakers taking action to fund the Children’s Health Insurance Program for the new year. States use those dollars to provide care for about nine million children of the working poor, including 22,389 at last count in Arizona.

The Arizona Department of Health Services estimates that the Arizona Health Care Cost Containment System, or AHCCCS, Arizona’s Medicaid program, pays for more than half of the estimated $115 million spent every year on asthma-related emergency room visits and hospitalizations.

Arizona missed its own deadline to send a waiver to the federal government asking for work requirements for able-bodied adults on the state’s Medicaid program.

Arizona already knows what will happen if its Medicaid program falters. In 2011, the state froze enrollment for childless adults in its Medicaid system, leading to more than 160,000 left without coverage in a relatively short amount of time.

In his ruling this morning upholding the Medicaid expansion, Maricopa County Superior Court Judge Douglas Gerlach wrote that the 36 GOP legislators challenging the measure failed both to prove that the hospital assessment was a tax instead of a fee and that it didn’t meet the exemptions laid out in Prop 108.

The recent experiences of several other states bode well for Gov. Doug Ducey’s attempt to get federal approval for a package of proposed reforms to Arizona’s Medicaid program.