How we got to the new plan for restoring, expanding AHCCCS

img-3In her State of the State address on Jan. 14, 2013, Arizona Gov. Jan Brewer unveiled a plan to restore and expand Arizona Health Care Cost Containment System (AHCCCS) coverage to childless adults up to 100 percent of the federal poverty level (FPL) and Arizona citizens up to 133 percent of FPL.

This would mean restoring AHCCCS eligibility for approximately 240,000 adults and expanding AHCCCS to 133 percent of the Federal Poverty Level. Combined, these steps give an additional 300,000 low-income Arizonans AHCCCS coverage over the next four years (2016).

Those two steps would ensure that Arizona is eligible for federal matching funds of approximately $7.9 billion over the next four years. This economic decision would help revitalize our state economy, strengthen the healthcare community and empower vulnerable patients.

To fully appreciate the significance of Governor Brewer’s announcement during the recent State of the State address, it’s important to consider what led to it. The Arizona Hospital and Healthcare Association (AzHHA) has created the following timeline of key dates, which begins in the voting booth more than a decade ago:

  • Nov. 7, 2000— Arizona voters approve Prop 204, which expands AHCCCS eligibility to all Arizona citizens earning up to 100 percent FPL ($15,510 for a family of two).
  • 2011 Legislative Session— Faced with a state economy in steep decline, Arizona lawmakers decrease AHCCCS funding by $2.6 billion in annual reductions. As a result, AHCCCS closes new enrollment for childless adults on July 8, 2011. AHCCCS continues to provide benefits to childless adults enrolled before that date who also maintain their AHCCCS eligibility.  The result? More than 140,000 low-income childless adults are no longer covered by AHCCCS. With no other options for healthcare, these individuals flood non-profit medical clinics and hospital emergency departments. Since the freeze, the cost of uncompensated care at Arizona’s hospitals has doubled.
  • Feb. 15, 2011— Arizona receives a waiver from the federal government, allowing the state to provide AHCCCS coverage for childless adults under 100 percent FPL and to receive a federal match for doing so.
  •  June 28, 2012— The U.S. Supreme Court decides in favor of the Affordable Care Act, leaving Arizona’s Governor Brewer to decide if the state will expand AHCCCS to people with incomes between 100 and 133 percent FPL.
  • Dec. 10, 2012— The federal government announces that states cannot partially expand their Medicaid programs and receive full federal funding. This means that Arizona, which already provides AHCCCS coverage for childless adults up to 100 percent FPL, cannot receive enhanced federal funding unless it expands AHCCCS coverage from its current 100 percent FPL to 133 percent FPL. This change would affect 57,000 Arizonans.
  • Jan. 14, 2013—Governor Brewer proposes expanding AHCCCS to 133 percent FPL. Supported by the hospital and business leaders, the expansion plan includes a provider assessment.

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