Arizona Plans to Throw Half of Its|Medicaid Recipients off the Rolls

PHOENIX (CN) – To save $500 million illegally, Arizona plans to throw half its Medicaid recipients off the rolls by next year and cap the number of people eligible for Medicaid next week, despite a voter initiative that requires such coverage for any Arizonan at or below the federal poverty line, poor people say in a Superior Court complaint.

     The Arizona Health Care Cost Containment System serves 1.3 million people. Lead plaintiff Anthony Fogliano sued the state and AHCCCS Director Tom Betlach in Maricopa County Court.
     Fogliano challenges recent actions by the Legislature and AHCCCS.
     “In 2011, the Legislature enacted legislation giving AHCCCS the authority to deny or terminate coverage for populations covered by [the successful voter initiative] Proposition 204,” the complaint states. “In response, the governor requested permission from the federal government to freeze enrollment and eliminate coverage for persons protected by Proposition 204. Subsequently, AHCCCS issued a proposed rule and announced its intention to freeze enrollment of adults without dependent children on July 1, 2011, and, at its discretion, exercise its authority to terminate or deny coverage for some or all of those individuals to bring AHCCCS operations within legislative appropriations.
     “As a result of the legislation and proposed rule, persons eligible for AHCCCS under Proposition 204, including persons with chronic, severe and significant medical conditions, will not receive the medical care they need and their health will be adversely affected.
     “Plaintiffs seek declaratory and injunctive relief to enjoin defendants from taking any action to freeze enrollment, deny or terminate health care coverage or in some other way eliminate or reduce the number of eligible persons covered by the AHCCCS program currently and in the future for individuals protected by Proposition 204 and the Voter Protection Act.”
     Arizona voters approved Prop. 204 in 2000. In 1998, state voters approved a constitutional amendment called the Voter Protection Act, “to prevent the Legislature from enacting legislation that defeated or frustrated the intent and purpose of voter-approved measures,” according to the complaint.
But this year, the Legislature passed and the governor signed Senate Bill 1001, requiring AHCCCS to “request that the federal government waive Arizona’s obligation to provide benefits to optional groups, including individuals up to 100 percent of the federal poverty level.”
     On March 31, Gov. Jan Brewer submitted an amended waiver proposal to the Centers for Medicare and Medicaid Services. Brewer “requested authority to freeze enrollment for adults without dependent children effective July 1, 2011, instead of terminating coverage for that population on Oct. 1, 2011.”
     She also requested unlimited authority for AHCCCS to set eligibility based on funding, the complaint states.
     “The enrollment plan would be part of AHCCCS’ proposed ‘phase out’ plan for adults without minor children,” the complaint states.
     “AHCCCS estimates that with such a freeze, the number of individuals enrolled would drop by half in fiscal year 2012.”
     Though not filed as a class action, the five plaintiffs say, “This case is brought on behalf of low-income Arizona residents who are eligible for medical services through Arizona’s Medicaid program”.
     Named plaintiffs include four poor sick people, the Mountain Park Health Center, and a former organizer for Proposition 204.
     The ill plaintiffs worry they will not be able to see their doctors or get medicine if Arizona’s plan is allowed to stand.
     Lead plaintiff Fogliano takes thyroid and radiation medication so his thyroid cancer does not return, and sees a pain specialist and an orthopedic surgeon.
     Gov. Brewer on April 6 “signed various budget bills enacted by the Legislature that reduced the appropriation to AHCCCS for FY 2012 by over $500 million,” the complaint states.
     On April 29, AHCCCS issued proposed rule R9-22-1443, to freeze enrollment of adults without dependent children on July 1, and deny eligibility to people who become eligible after July 1.
     If Uncle Sam grants the state’s amended waiver request, “individuals covered by Proposition 204 who are adults without dependent children with incomes at or below 100 percent of the poverty level, will be denied AHCCCS enrollment effective July 1,” but if the waiver is denied, AHCCCS beneficiaries “may be terminated from the program altogether” on Oct. 1, because of limited funding, according to the complaint.
     Eliminating adults without dependent children on July 1 is expected to save AHCCCS $190 million; eliminating parents with incomes from 75 percent to 100 percent of the federal poverty level is expected to save the state $17 million.
     Plaintiffs seek declaratory judgment and injunctive.
The are represented by the Arizona Center for Law in the Public Interest, the William E. Morris Institute for Justice, and the Arizona Center for Disability Law.

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