State-Federal Standoff Costly For Uninsured

Arizona unlikely to expand AHCCCS, leaving large number of Gila County families without medical coverage

Governor Jan Brewer

Photo by Andy Towle. |

Governor Jan Brewer


The standoff between Arizona Gov. Jan Brewer and the federal government over health care will likely deny thousands of Gila County residents health coverage.

Brewer recently notified the federal government that despite spending millions in federal grants so far, Arizona won’t set up an insurance exchange to help people buy health coverage and likely won’t fully expand coverage required by the Affordable Care Act.

Brewer concluded that the state couldn’t afford the extra costs of setting up an exchange, which she said would be so tightly controlled by the federal government that the state wouldn’t have much autonomy in running the system anyway.

The federal government responded by saying it would set up the exchange in Arizona and 16 other states that have refused to participate. And if Arizona doesn’t fully expand AHCCCS coverage to people making less than 133 percent of the poverty level, it won’t get the almost 100 percent coverage for any groups it does add.

As a result, leaders in the Legislature have said they will likely leave the coverage limit at the poverty line for only women and their children, dooming hopes the state would restore coverage that knocked 100,000 people off AHCCCS two years ago.

The decision will likely hit hard in Gila County, where 30 percent of the population relies on AHCCCS for coverage — most of them women, children and impoverished nursing home residents.

Recent cutbacks have already knocked thousands of Gila County residents off the AHCCCS rolls.

The state Legislature shut down a voter-approved expansion of the program to cover impoverished, childless adults and children without health insurance in families making up to 133 percent of the federal poverty level — which is about $31,000 for a family of four. The poverty line stands at about $22,000 annually for a family of four.

Eliminating some 100,000 from the program saved the state about $1 billion, but at the cost of about $2 billion in matching federal funding. Normally, the federal government covers about two-thirds of the cost of the program. The federal government will pay 100 percent of the cost of people added to the health care rolls for the first couple of years after the Affordable Care Act takes place.

That earlier state decision in Gila County reduced the number of children covered by about 500 and the number of childless adults covered by several thousand, according to state estimates.

Brewer had hoped that the federal government would agree to pay 100 percent of the cost of restoring the people cut in the past few years — including impoverished, childless adults and children in families with incomes up to 133 percent of the poverty level.

However, the federal government instead said it would provide the 100 percent payment only if the state provided AHCCCS coverage for anyone without insurance making up to 133 percent of a poverty wage.

With the more generous federal match, it would cost the state about $135 million to restore the people cut during the budget crisis. Without the standard federal match, it would cost the state closer to $500 million, say state officials.

Top state Republican legislative leaders have said that without the 100 percent federal match, they will not support restoring the health coverage cuts.

The federal government can’t force any state to expand its Medicaid program, thanks to the U.S. Supreme Court decision that upheld most of the provisions of the Affordable Care Act. That decision said that the federal government couldn’t threaten to cut existing Medicaid funding if states refused to expand eligibility.

The deadlock will likely cost lives, according to the results of a New England Journal of Medicine study.

That study examined death rates in Arizona and other states that had expanded eligibility. The study found a 6 percent drop in the death rate, which the researchers attributed to the expanded health coverage. The Legislature subsequently eliminated the expanded coverage.

Other national studies attribute about 45,000 premature deaths annually to the lack of medical insurance. That’s about three times as many Americans who die as a result of murder each year.

Arizona has one of the highest uninsured rates in the country —and Gila County among the highest in the state.

About 51 million Americans lack health insurance. Estimates suggest the Affordable Care Act would reduce that total by about 32 million. However, many of those gains rely on the expansion of state Medicaid programs.


ALLAN SIMS 4 years ago

How many times have we heard this cry in your beer liberal hype, quoting “Other national studies” about all these people dying as a result of people wanting to keep their own money in their own pockets?

If all those folks had died, as this person and liberals at large claim, then we’d have the courts sunk in wrongful death lawsuits. And, that hasn’t happened. Now, suddenly, all those people are going to die, who haven’t died before? Why is that? Oh, because the state bucks the feds? That has to be it. The all knowing, all seeing gov’t has to be right. None of those ‘studies’ could possibly be slanted, could they?

But, the proof is in the history. How many wrongful deaths have occurred in Arizona, due to lack of coverage? In the studies that were flaunted around concerning passing ObamaCare, it was estimated that many hundreds of thousands would die because of lack of it. Yet, we had the lack of it before, and those hundreds of thousands didn’t die, did they?

Thank you Gov. Brewer for your diligence.


Bernice Winandy 4 years ago

Could it be that many of the deaths caused by lack of treatment are people who do not have anyone to speak for them? Therefore, there is no one available to start a wrongful death.

We should remember that uninsured people can end up in the emergency room. In the emergency room the care is the most expensive. The USA taxpayer ends up paying the bill. To avoid picking up these expensive tabs, would it be better to have everyone insured?

I am not trying to start an argument, I just was wondering.


ALLAN SIMS 4 years ago

I’m sure that you are right to some extent.

But, for folks to jump out and claim that forcing us to adhere to government programs is going to save more than 40,000 lives is just plain wrong. We haven’t been burying that many indigents, have we? Or, maybe I’ve missed something in the obituaries?

BTW, it hasn’t been the taxpayer footing the bill for emergency room over-usage. It has been those who go to the hospitals and doctors that foot the bill. For, they simply raise everyone else’s bill to cover their cost. And, we in America have, though grumbling, accepted that as our duty to see that the needy are cared for. Now, suddenly we are begging the gov’t must step in, because of all those who are going to die, who didn't die before?

They didn’t die before, and they wouldn’t without this push to cover them, but we are told they will until even the conservatives begin to believe it. Joseph Goebbels once said that if you tell a lie long enough people will believe it.

That’s what we have here.


Kim Chittick 4 years ago

I have no problem with the government providing medical care for children who are truly in need. However, I personally know of a couple who is perfectly able bodied. They each do pick up work here and there and get paid "under the table". My husband offered the woman (who loves working with plants, etc) work maintaining our yard. He was informed that she charges $35 per hour!! She also offered to walk my dog for $10 per hour! I suggested to her that she check into a job at Home Depot in the garden department, whereupon she informed me that "Home Depot wouldn't hire me because I couldn't pass their drug test. You know I like to smoke pot." Ummm, no, no I didn't know that!. All of this is relevant because the woman mentioned a couple of years ago that she got approved for AHCCCS and food stamps. As a matter of fact, she was very impressed by the fact that now food stamps are "like a credit card, so you can maintain your dignity". You know what? I don't care about your dignity when you are more concerned with smoking your joints and sitting on your lazy drugged out rear watching cartoons, than with actually being a productive member of society.

Furthermore, within the last 6 months, this woman's unwed and pregnant daughter showed up in Arizona from another state. Just weeks after she arrived, she gave birth on the Arizona taxpayers dime. She stayed another couple of weeks, and then her baby daddy arrived to pick her and baby up and bring them back to the other state.Although they did come back to visit for 3 weeks over the holidays.

If I knew to whom I could report this gross abuse of the system, I would absolutely not hesitate.


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