PHOENIX — Arizona is likely to see more than 380,000 people lose their Medicaid insurance coverage and $2.5 billion in lower health care spending under the plan currently being pushed through Congress to replace former President Barack Obama's health care law, according to a new state report.
The analysis by the state's Medicaid plan obtained by The Associated Press Friday shows keeping most of those people insured would cost the state nearly $500 million a year by 2023. In a Republican-led state where tax increases are nearly impossible to enact, that's extremely unlikely.
The report looks at the patients who gained coverage under a Medicaid expansion pushed through in 2013 by former Gov. Jan Brewer over opposition from many in her own party. It now covers about 400,000 Arizonans out of the 1.9 million covered by Medicaid in the state.
Of those 400,000, about 316,000 are childless adults who earn less than the federal poverty limit, and 81,000 earn between 100 percent and 138 percent of the limit.
Brewer said in an interview earlier this week that "it weighs heavy on my heart" when she thinks of the current Republican plan to repeal and replace Obama's law.
"It just really affects our most vulnerable, our elderly, our disabled, our childless adults, our chronically mentally ill, our drug addicted," she said of the potential elimination of coverage for the expansion population. "It will simply devastate their lives and the lives that surround them. Because they're dealing with an issue which is very expensive to take care of as a family with no money."
She spoke after the state Court of Appeals upheld a hospital assessment that helps pay the state's current share of the expansion costs.
The Congressional Budget Office estimated that 14 million fewer Americans would have Medicaid insurance by 2026 under the plan, while the cuts would save the federal government $880 billion between 2017-2026.
Gov. Doug Ducey said earlier this week that he isn't pleased with the current proposal.
"I've said that I don't want to see anybody have the rug pulled out from underneath them, and that's what I'm going to be advocating," he told reporters Tuesday. "I have concerns with the bill as its written today."
Ducey said he has the ear of the state's congressional delegation and the new Secretary of Health and Human Services, Tom Price, and expects to see changes. He was on a call with White House officials talking about the health law on Tuesday.
"I think you're going to see a different bill if it does get out of the House, if it does get out of the Senate, than the bill you see today," he said.
Brewer too has a voice, and she's making it heard. An early and vocal supporter of President Donald Trump, she is dismayed with the current proposal and hopeful Trump steps in to see it changed.
"I'm hoping that there will be a coming together of the House and Senate and people weighing in will get heard," Brewer said. "I don't believe that Donald Trump wants to damage these people. He promised when he campaigned that he would not do that to them. I hope he maintains that clear thought moving forward."
Trump, however, seemed to embrace the plan even more on Friday when he agreed to add fresh Medicaid curbs to the House Republican health care bill to bolster its support among the most conservative members
"I just want to let the world know I am 100 percent in favor" of the measure, Trump said at the White House after meeting around a dozen House lawmakers and shaking hands on revisions. "We're going to have a health care plan that's going to be second to none."
The analysis released Friday by Arizona's Medicaid plan looks at several scenarios, none of them pretty for the poor Arizonans currently on Medicaid.
Freezing the current enrollment for the two populations covered by expansion is one option. Another is to only freeze those in the plan who earn above the poverty level. But the current GOP plan would cut matching funds to states, increasing costs. Keeping just the below-poverty level population insured would cost $30 million more next year and going up to $478 million by 2023.
An optional plan to help the state stabilize private insurance markets would also be costly. The state's share would be nearly $69 million by 2023.
— AP Reporter Alan Fram in Washington contributed to this report.