The real health care debate: Medicaid expansion

By Luige del Puerto

Arizona Capitol Times

Gov. Jan Brewer’s decision to not pursue a state-operated health care exchange sets the stage for a showdown over how to deal with Arizona’s uninsured population.

Health care industry representatives and Capitol insiders said ditching an Arizona-run exchange has turned the conversation to the Arizona Health Care Cost Containment System, the state’s Medicaid program. Specifically, the question is whether the state should again pay for the health insurance of all low-income residents.

Faced with the worst fiscal crisis in recent history, Brewer and the Republican-led Legislature in 2011 froze the Medicaid enrollment of low-income Arizonans who have no dependent children, despite a voter mandate to provide health coverage to all residents who earn up to 100 percent of the federal poverty level.

But since the economy is recovering, albeit at a slow pace, hospitals and others in the health community are lobbying hard for the state to restore that coverage.

The health sector is arguing that it makes economic sense and is what the public mandated in 2000, when voters approved Proposition 204, which expanded Medicaid eligibility to include everyone living in poverty, including adults without dependent children.

Brewer has yet to make up her mind whether to fight for health coverage for all of those Arizonans. But her decision would likely hinge, in part, on whether the federal government decides to pay a much bigger share than normal of the cost of providing health care coverage to Arizonans.

Here’s why.

Continued:

 

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