State Lawmakers Should Vote To Expand Ahcccs

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Gov. Jan Brewer has made a convincing case for accepting roughly $2 billion in federal funds annually to expand the Arizona Health Care Cost Containment System, despite the qualms of the lawmakers representing Rim Country.

Elsewhere on this page, Rep. Brenda Barton (R-Payson) offers her concerns about the governor’s plan to add some 300,000 people to the AHCCCS rolls, with the federal government at least initially footing the bill in accordance with the Affordable Care Act. Rep. Bob Thorpe (R-Flagstaff) and Sen. Chester Crandell (R-Heber) have previously expressed similar concerns.

Rep. Barton raises some strong points. She expresses understandable skepticism about whether the federal government will follow through on its promises to pay 100 percent of the cost of adding childless adults making up to 133 percent of a poverty level wage to the AHCCCS rolls. Certainly, the federal government has repeatedly broken faith with the states when it comes to unfunded mandates. But then, the state Legislature has an equally poor record when it comes to costs it imposes on towns, counties and school districts.

Gov. Brewer has protected the state from the consequences of a complete collapse of the federally funded effort to dramatically reduce the ranks of the medically uninsured. Gov. Brewer’s proposal would again shrink AHCCCS if the federal match falls below 80 percent.

Please note, the federal government now pays about 66 percent of the cost of the current AHCCCS population, which mostly covers impoverished women, children and seniors in nursing homes. In Gila County, AHCCCS covers a sobering 30 percent of the population.

Moreover, Gov. Brewer has enlisted the support of most of the state’s hospitals for a new health care tax to cover any cost to the state in the expansion, since the measure will almost certainly significantly reduce hospitals’ burden of uncompensated care.

Rep. Barton also expresses concern about whether the Affordable Care Act will prove much more expensive than the federal government now expects. Moreover, she’s concerned new mandates like coverage of pre-existing conditions, elimination of lifetime caps, coverage of preventive care and limits on the differences in rates based on age could result in big increases in the cost of medical insurance for everyone.

We share many of those concerns.

But they’re not good reasons for Arizona to spurn the promised $2 billion annually in new federal funds. The Affordable Care Act will extend coverage to an estimated 32 million of the nation’s 50 million uninsured. That will hopefully make a dent in the 48,000 premature deaths caused by a lack of medical insurance every year in this country.

Clearly, the Affordable Care Act has serious flaws — mostly the failure to include any effective way to contain the spiraling cost of medical care, which continues to rise at about twice the underlying rate of inflation. We spend two to seven times as much per person on medical care as any other country — but no longer rank at the top on most measures of health. The system squanders money on overhead and unproven treatments that do more harm than good — especially at the end of life. Adding 32 million people to a wasteful system will likely make that problem even worse.

Still, the lack of medical insurance kills perhaps 48,000 people each year. Despite its flaws, the Affordable Care Act will save lives. The Legislature must not abandon its citizens — and spurn our fair share of funding.

We hope our representatives in the state Legislature will support the governor’s difficult but necessary proposal.

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