3/26/2013 11:38:00 AM Guest Column: Brewer's plan to restore and expand Arizona's Medicaid program a positive step forward
Bill Bradel President and CEO of Flagstaff Medical Center
Flagstaff Medical Center (FMC) takes its mission to provide exceptional care and transform the health of the communities it serves very seriously. That's why we support Arizona Governor Jan Brewer's proposal to restore and expand Arizona Health Care Cost Containment System (AHCCCS), Arizona's Medicaid program.
As you might remember, in 2011 when Arizona was faced with an economy in a steep decline, lawmakers voted to decrease AHCCCS funding by $2.6 million. One of the ways the decrease was accomplished was by closing enrollment to childless adults. As a result, more than 140,000 low-income, uninsured Arizonans are no longer covered by AHCCCS. In Coconino County alone, 4,600 people lost their AHCCCS coverage over the past two years.
At FMC, we've seen the aftermath of that decision. For some, the Emergency Department has become their source for primary care. Others have chosen to delay or forgo medical care until their condition became so serious they ended up in the Emergency Department. With the reduced AHCCCS enrollment, FMC has experienced a nearly three-fold increase in its uncompensated care - from 2.4 percent of all patients in 2010 to 6.1 percent in 2012.
The governor's proposal calls for restoring AHCCCS coverage for approximately 240,000 adults and expanding eligibility to as much as 133 percent of the federal poverty level (FPL). Combined, these actions would extend AHCCCS coverage to an additional 300,000 low-income Arizonans through 2016.
Humanitarian and economic benefits
First and foremost, the AHCCCS expansion would have a real impact on the lives of hundreds of thousands of Arizonans. No longer would they have to skip primary healthcare. Instead, they would be able to go to the doctor for routine checkups and health maintenance, and for timely follow-up when they are sick.
Secondly, by expanding AHCCCS, $1.6 billion will be injected into the state's economy annually. In all, Arizona would be eligible for matching funds of approximately $7.9 billion from the federal government over the next four years. To receive these enhanced federal funds, Arizona must expand AHCCCS coverage from the current 100 percent of FPL to 133 percent of FPL.
Hospitals stepping up to pay for expansion
FMC and hospitals throughout Arizona want to be part of the state's healthcare solution. That's why we endorse the Medicaid provider assessment that is part of the governor's AHCCCS plan. The assessment is similar to ones in place in 49 other states and the one already being assessed to Arizona skilled nursing facilities and health plans. It cannot be passed along to patients or third-party payers such as insurance companies.
With the provider assessment, Arizona has the opportunity to pay for coverage through a 10 to 1 rate of return of federal dollars for every dollar invested by Arizona. The federal money Arizona stands to receive will take the pressure off our state's general fund and allow for more people to receive the right healthcare at the right time in the right location.
FMC Board Endorsement
The FMC Board of Directors formally endorsed the governor's proposal through a resolution at its February meeting.
Arizonans have voted twice to expand Medicaid. The governor's proposal not only respects the will of the voters who have strongly supported coverage for low-income, uninsured childless adults, it takes it just a bit further in order to leverage federal support and diminish state expenses. By lowering what the state pays for healthcare, more money is available for other key services.
Since 2011, our state's economy has improved. As the governor has said repeatedly since unveiling her AHCCCS proposal in January, now is the right time to restore AHCCCS to childless adults. It truly is the right thing to do.
I encourage you to contact your state representatives and let them know your opinion about the governor's AHCCCS plan. More information, is available at www.azahcccs.gov/publicnotices/MedicaidExpansion.aspx.