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Arizona will seek federal permission to limit Medicaid
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Arizona will seek federal permission to limit Medicaid

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PHOENIX — Gov. Doug Ducey signed legislation Friday requiring the state to ask federal permission every year, forever, to impose work requirements on Medicaid recipients and kick them out of the health-care program after five years.

The federal government has rejected similar requests from other states.

In a prepared statement, gubernatorial press aide Daniel Scarpinato said the legislation will “ensure that we have a responsible Medicaid program that protects taxpayers and provides care to those who need it the most.”

Former Gov. Jan Brewer vetoed a nearly identical measure last year, saying kicking potentially a half million people out of the Medicaid program would not only harm them, but bring the state’s health-care system “to a breaking point.”

She said those who are not getting health insurance through Medicaid will instead show up in hospital emergency rooms, get care and then be unable to pay their bills.

The fight comes down to the question of the role of the government in providing health care for those who cannot afford it.

In Arizona, those making up to 138 percent of the federal poverty level qualify for the Arizona Health Care Cost Containment System, the state’s Medicaid program. That translates to $27,310 for a family of three.

Sen. Brenda Barto, R-Phoenix, said during hearings on her legislation that there is “a serious problem of welfare benefits becoming an incentive not to work.” She said the money being spent on this is “unsustainable.”

Legislative budget staffers say the estimated savings to the state if all the waivers were granted would probably be less than $2 million a year. But Barto said it’s not just state dollars that concern her or legislators elsewhere.

“What we’re trying to do as states ... is to take control in some way and stop incentivizing for those people that use it in that respect,” she said.

“We want certain controls in order to help the federal government keep its obligation that they’ve made, contract with the poor, receiving health care,” Barto said. “But we want to make sure that we’re really serving those that are needy.”

Federal regulations do not allow states to impose the limits in this new law.

The Centers for Medicare and Medicaid Services, however, has permitted states to seek waivers from their rules to find better ways to provide care. For example, the agency recently allowed Indiana to impose some co-payments and premiums on those in that state’s program.

“We have supported projects that reflect the state’s unique objectives,” said CMS spokesman Aaron Albright.

But he said any waivers require “keeping faith with the law’s goals and consumer protections.” Albright said his agency has not granted waivers like the work requirement or the lifetime limit Arizona wants to any other state.

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