Feathered Bastard

Jan Brewer's Medicaid Cuts Copacetic, Claim Feds

Governor Jan Brewer seems to have scored a "win," if you can call it that, in her effort to cut hundreds of thousands of childless adults from the state's Medicaid program, otherwise known as the Arizona Health Care Cost Containment System, or AHCCCS.

Brewer recently signed legislation authorizing her to seek a waiver from Kathleen Sebelius, President Obama's Secretary of Health and Human Services. A letter asking Sebelius to release Arizona from it's commitment was sent out in early February. 

In that letter, Brewer told Sebelius she wanted to reduce or eliminate Medicaid coverage for 280,000 Arizonans, most of them adults sans tots.

Many local Democrats have been skeptical that Sebelius would grant the request, and have criticized Arizona GOPers for attempting to rectify an $800 million budget hole without knowing whether or not the Obama administration would issue a waiver.

But in a letter today to Governor Brewer, Sebelius indicated that Arizona did not need permission from the feds to slash and burn.

Sebelius informed Brewer that,

I do want to make you aware that the MOE provision in the Affordable Care Act does not require Arizona to renew its demonstration as is, beyond its expiration date of September 30,2011.  Waivers are time-limited commitments - both for a state and for HHS - and neither the Affordable Care Act nor Medicaid law or regulations prior to its enactment require a state to renew a demonstration beyond its expiration.  Arizona may choose to terminate its current demonstration on September 30, 2011 and either not pursue a new demonstration or pursue a different demonstration. Any reduction in eligibility associated with the expiration of your demonstration for individuals whose eligibility derives from the demonstration (for example, the childless adult population) would not constitute an MOE violation.

The sound you're now hearing is the death rattle of the uninsured. According to the Grand Old Party, you deserve your fate. The Dems, alas, have no such ideological justification.

Democratic state Senator Kyrsten Sinema, who's been relentless in berating Brewer and the Republicans over the issue, was obviously disappointed by the letter. 

"It would have been wonderful if we'd known this much sooner," she told me. "It's unfortunate to learn it at this late date."

Sinema vowed a lawsuit on behalf of patients cut off from their medical coverage, pointing out that the voters of Arizona approved an expansion of Medicaid benefits in 2000 with Prop 204, and that the governor and the legislature lacked the authority to override that voter-approved mandate.

Sinema said there was one silver lining in the announcement: Brewer had counted on a denial of her request to beat up on the Obama administration, but Sebelius' letter robbed the governor of her punching bag.

"Her plan was to blame the Obama administration for not letting her cut [AHCCCS benefits]," she explained. "She can't say that it's Obamacare that's keeping her from cutting...Now she has to take responsibility for it."

Good point. But if the intended lawsuit fails to secure an injunction preventing the cuts from going into effect, it'll be cold comfort to those trying to survive minus Medicaid.

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Stephen is a former staff writer and columnist at Phoenix New Times.
Contact: Stephen Lemons