A major part of President Barack Obama’s controversial health care plan, one that gets relatively little notice, is the expansion of Medicaid. Yet that part of the Affordable Care Act is to provide health care coverage to about half of the 30 million people expected to eventually gain it through the program.
This change is a major issue in Arizona. The state is emerging from years of extreme budget difficulties that make expansion questionable, but at the same time many low-income Arizonans without health coverage are causing major problems for hospitals here.
Gov. Jan Brewer has stepped up with a plan to add about 300,000 to Medicaid, known in the state as the Arizona Health Care Cost Containment System. Not only that, but the governor apparently is the first in the nation to suggest how to actually pay for the expansion — with a tax on hospitals.
The federal law offers a big incentive: payment for all the cost of the expansion for three years, then stepping it down to 90 percent payment. States such as Arizona are wisely wary of incentives that require big expenses later. Yet Arizona hardly can afford not to enter the arrangement, especially because of the burden being borne by hospitals.
Brewer, whose conservative credentials are well known, earlier decided against having the state set up an insurance exchange under the law, something that likely would have resulted in major costs for the state with still-unknown federal rules hanging over its head. That also was the correct decision.
For hospitals such as Casa Grande Regional Medical Center, which has many millions of dollars in uncompensated care annually, the 6 percent proposed tax is likely to sound like a good deal. AHCCCS expansion would pay many of those bills and could well be the difference in maintaining financial health for the hospital, which is a tremendous resource for this area.
Brewer’s plan will face a thorough airing in the Legislature, and challenges already have surfaced. But Arizona needs it. This is one case where federal assistance is too good to pass up.