Phoenix, AZ – In her State of the State speech, Brewer repeated the call she
made on lawmakers in March to approve a temporary hike in state
sales taxes to deal with the deficit. The governor also said,
again, that there will need to be further cuts in spending and
proposed future limits on the growth of government. But Brewer
came up with a new specific Monday. She wants voters to
reconsider their decision a decade ago where they agreed to
expand the Arizona Health Care Cost Containment System, the
state's Medicaid program, to cover everyone below the federal
poverty level. That currently translates to about $18,300 for a
family of three.
(Contrary to what voters were told, there is no such thing as
free health care. Supporters assured us that it would be covered
by tobacco revenue. But in reality, almost $1 billion of our
general fund deficit can be directly attributed to this enormous
Rolling back to pre-2000 levels would cut the maximum a family
could make and still get care by about two thirds. It also would
mean that about 300,000 of the more than 1.2 million people
enrolled in the program would be bounced. Brewer's contention
that voters were told the state's cost of the expansion would be
covered by tobacco settlement revenues is only partly true.
Lawsuits filed by many states accused tobacco companies of
racketeering, fraud and targeting minors with their advertising.
In a nationwide settlement more than a decade ago, the tobacco
companies agreed to change their practices and pay some money.
Arizona's share over a 25-year period was pegged at about $3.2
billion. There actually were two measures on the 2000 ballot
seeking to spend that money on expanded health care. One would
have limited the expansion to only the settlement funds
available; the other -- the one that got more votes and became
law -- committed the state to providing free care for everyone
below the poverty level, regardless of whether the tobacco
dollars were available. Her plan faces an uphill battle -- and
not only because she needs to convince voters to make the change.
Some of the fight will come from the Arizona Chamber of Commerce.
Organization president Glenn Hamer said those who are bounced
from AHCCCS rolls will not get the routine care they now are
provided. The result, he said, is these people will seek medical
care only when they are truly sick, showing up in hospital
emergency rooms. And hospitals are forbidden by federal law from
turning away patients in life-threatening situations. Hamer said
all that will do is force hospitals to shift costs.
(The stress is going to be put elsewhere. It's going to be
ultimately put on employers in the form of higher premiums. And
the higher premiums will cause some to drop coverage, which means
fewer Arizonans will receive their health care.)
Eve Shapiro, a pediatrician who helped craft the original 2000
ballot measure, also scoffed at Brewer's contention that coverage
needs to be scaled back because the state cannot afford it.
(To say that we can't afford to give people health care is pretty
counterproductive because the way to have a more economically
viable workforce is to have a healthy workforce. So it's kind of
shooting yourself in the foot.)
But Republican legislative leaders appear more than willing to
send the question of who gets coverage back to the ballot. Senate
President Bob Burns said the plan should be scaled back. He said
people should take more responsibility for their own health.
(It's hard for me to believe that one-sixth of the population of
the state of Arizona has to have government assistance in their
health care. They make choices in how they spend the money they
earn. So maybe health care needs to be put up in a little higher
And House Speaker Kirk Adams said it's even more basic than that.
He said the state just doesn't have the money to meet these kinds
of expenses. For Arizona Public Radio this is Howard Fischer.