By: Health Insurance
Submitted: 2009-10-20 15:17:06 | Word Count: 629
Republican Gov. Jan Brewer on Wednesday warned that health-care reform pushed by congressional Democrats figures to increase costs borne by states, creating a "devastating" situation for Arizona and other states already teetering on financial collapse.
Several proposals are working their way through Congress, but they share the goal of bringing health coverage to millions of Americans now going without. One approach is to expand Medicaid eligibility. The question is who should pick up the tab.
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With Arizona government already facing a $1.5 billion budget shortfall for the remainder of this year, Brewer called it "incomprehensible that Congress is contemplating an enormous unfunded entitlement mandate on the states." "I implore you to bear in mind the fiscal realities states are facing as we attempt to maintain responsible balanced budgets while preserving services for our most vulnerable residents," Brewer wrote in a letter to U.S. Sen. Max Baucus, the Montana Democrat spearheading health-care reform efforts in the Senate.
Brewer's concerns mirror those of more than a dozen of her fellow Republican governors. Their chief concern, expanding who is eligible for Medicaid, would force cash-strapped states to either cut programs in other areas or raise taxes, the governors say.
Baucus' proposal would expand eligibility under state Medicaid programs to households earning up to 133 percent of the federal poverty level, just over $22,000 a year for a family of four.
Arizona already provides free or low-cost health insurance
to roughly 1.3 million people living at or below the poverty level with the Arizona Health Care Cost Containment System, the state's version of Medicaid.
"We can't afford it," Brewer told The Arizona Republic on Wednesday. "We can't afford the AHCCCS program we have currently."
The governor did not provide an estimate of how many more Arizona residents would be eligible for Medicaid under Baucus' plan.
But to illustrate the potential burden, she outlined the additional costs the state could incur if all those who are now eligible to enroll but have not done so were to enroll.
If those 200,000 enrolled, the additional costs to the state could be as much as $4 billion over five years, she indicated in her letter.
Even without Medicaid expansion, critics view the program as a worsening drag on the budget. State General Fund contributions to AHCCCS grew by 230 percent over the past decade, Brewer said, and total program funding from all sources is slated to exceed $7 billion this year alone.
State Rep. Kyrsten Sinema, a member of President Barack Obama's task force on health-care reform, conceded that state costs are unworkable under the current Baucus proposal. Sinema, a Phoenix Democrat, said she prefers a competing House Democratic plan that would phase in the new state Medicaid costs over a period of years.
Health-care advocate Kim VanPelt said failure to act would be costly, as well, with the rising price of health care leading more employers to drop coverage, thereby swelling state Medicaid rolls.
"The solution isn't necessarily to say health-care reform shouldn't occur," said VanPelt, associate director for St. Luke's Health Initiatives.
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