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Health benefit cuts begin; AHCCCS enrollment frozen

WASHINGTON – As state Sen. Kyrsten Sinema sees it, Arizona began taking “unconstitutional and unconscionable” action Friday against some of the state’s most-vulnerable residents.

But as Chic Older of the Arizona Medical Association sees it, the state action is regrettable — but unavoidable.

“Our state is broke,” he said, which is why it began phasing out Medicaid coverage Friday for childless adults in the state.

“It’s a very difficult, complex situation,” Older said. “There’s not a bad guy.”

They’re referring to the first step in the state’s plan to save an estimated half-billion dollars in health care costs. That first step is expected to save $190 million and ultimately trim 100,000 beneficiaries from the rolls of childless adults in the state currently receiving Medicaid benefits.

Monica Coury, a spokeswoman for the Arizona Health Care Cost Containment System, said 1.35 million Arizonans currently receive some form of Medicaid benefits from the state. Of those, 225,000 get childless-adult benefits, a benefit that has to be renewed annually.

In a typical year, Coury said, about 100,000 of those people receiving childless-adult benefits would not be renewed because they moved out of state, earned more money or simply failed to reapply, among other factors.

As of Friday, the state stopped accepting new applications, which should lead to a natural reduction of 100,000 beneficiaries over the course of the year.

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Those who are still eligible for coverage will still get benefits, state officials say, and at the same level as before. But they will be transferred to a different category under the state Medicaid umbrella, the Supplemental Security Income/Medical Assistance Only program.

Coury said the changes in categories will not change the benefits and people shouldn’t notice any difference.

Federal Medicaid rules do not require coverage for childless adults, and Arizona has been one of only five states to offer that coverage. It did so after state voters in 2000 passed Proposition 204, which required that Arizona use Tobacco Settlement funds and other funds as necessary for the childless-adult benefits.

This year, those benefits became a casualty of the economic downturn and the subsequent state budget deficit. State lawmakers voted to cut the benefit and federal officials in June gave the go-ahead, even as they said they regretted the decision.

Opponents tried to block the move in court, but Maricopa County Superior Court Judge Mark Brain last week rejected a request from El Rio Community Health Center and others to halt the change, a move hailed by Gov. Jan Brewer. The federal and state governments agreed to continue accepting applications for one more week before imposing the freeze.

Even though state officials insist that beneficiaries should not notice a difference, Sinema and others remain apprehensive.

“We just don’t know that everyone will get coverage,” said Sinema, a Phoenix Democrat. She expressed particular concern that a mentally ill person denied coverage could pose a serious risk to themselves and others.

Older agrees there is a definite concern for those who will go without coverage, but he does not think the government is trying to “be difficult or malicious.”

The agreement with the federal government requires that the state reach out to currently enrolled beneficiaries to make sure they have adequate notice of changes to coverage and deadlines for applying.

Several private groups have also started initiatives to make sure that childless adults who are eligible for coverage get it. Keogh Health Connection, a Phoenix non-profit, got together with other area health care advocates and launched the “Don’t Get Dropped AZ” campaign to urge recipients to renew before Friday.

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Despite those efforts, Eddie Sissons, the executive director of the Arizona Foundation for Behavioral Health, worried that the new process would be too confusing and too much of a hassle for people who need services.

“There are numerous doors to get into AHCCCS, but most of us don’t know which door to go into,” Sissons said.

“People don’t pay attention – they’re not diligent,” she said. “If they screw up, they’re going to be out of coverage, end of sentence.”

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