The Health-Care Mirage

GOP boosters say Arizona's medical system for the poor should be a model for national health-care reform. But three federal investigations question whether Arizona's system is any less expensive than traditional Medicaid plans.

Two thirds of AHCCCS members are made eligible for health care through a single federal welfare program--Aid for Families With Dependent Children. When a recession swells the AFDC rolls from their current low levels, the number of people enrolled in AHCCCS will almost automatically increase.

A second looming statistic: The fastest-growing segment of the Arizona population is people over the age of 85. In fact, Arizona has the second-largest number of people that age, by population, in the country.

The Arizona Long Term Care System, the program for the physically or mentally disabled and the elderly, is the fastest-growing part of AHCCCS.

Experts inside and outside the program say health care for the elderly may one day represent the biggest cost in the AHCCCS system.

It all adds up to a triple whammy for Arizona's medically indigent.
Whenever recession hits, increased AFDC numbers will increase AHCCCS' costs. The program's long-term-care expenses will continue to grow. At the same time, federal spending on health care will be cut, or grow only slowly.

And, after years of tax cutting by Republican revolutionaries, the state may not have anywhere near the tax revenue necessary to deal with the rising demands on AHCCCS.

In the face of such a financial squeeze, Arizona may be all but forced to tighten eligibility rules and force large numbers of poor people out of AHCCCS.

So, to get their health care, the poor could begin showing up at emergency rooms in public hospitals again, generating enormous costs and leaving county governments to pick up the tab.

Sound familiar?

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