PHOENIX (AP) – Arizona Gov. Doug Ducey says a U.S. Senate proposal repealing much of President Barack Obama's health care law falls short of what is needed to provide for the state's Medicaid population.
The Senate bill would largely end the expansion of Medicaid that covers about 14 million Americans, cut the taxes that paid for expansion and end the insurance mandate for individuals and businesses. But it maintains the health insurance marketplaces and tax subsidies that help people pay premiums.
The governor sent a letter to Sen. John McCain this week outlining what must be included to get his backing. Ducey spokesman Daniel Scapinato said Friday that an analysis of the Senate proposal shows the five areas Ducey identified aren't addressed.
McCain said Thursday he wanted to hear Ducey's opinion before deciding if he supports the bill.
Ducey wants a slower phase-out of higher Medicaid expansion matches, higher inflation adjustments, elimination of a penalty for states that expanded parts of Medicaid early, and explicit flexibility for the program covering 1.9 million Arizona.
New bill could cost Arizona $7 billion
Arizona's Medicaid agency says a new U.S. Senate proposal repealing much of former President Barack Obama's health care law would cost the state at least $7.1 billion through 2026.
The analysis released Friday says the costs occur even if the state freezes enrollment in expanded Medicaid. Currently, approximately 400,000 Arizonans receive coverage through Medicaid.
Changes to federal matching payments for the state's 1.9 million Medicaid recipients would cost $2.9 billion. Limiting inflation adjustments would cost $2.2 billion.
Another $2 billion loss would occur when a hospital assessment that pays the state costs of covering 82,000 people in the expanded program and 319,000 childless adults stops. That will happen in 2022 when federal matching rates hit an 80 percent trigger in the 2013 state law authorizing expansion.
Raising taxes to replace the money is unlikely in a Republican-controlled state.
Hospital association calls bill 'devastating'
The association representing Arizona's hospitals says the Senate bill repealing much of the Affordable Care Act would be devastating to millions of Americans who rely on Medicaid for their care.
The Arizona Hospital and Healthcare Association issued a statement after Thursday's release of the Senate bill saying it has been calling on leaders in Washington for months to find a workable replacement. It called the version passed by the House last month "a categorical failure" and said the Senate version is "equally troubling."
AHHA says the more gradual phase-out of Medicaid expansion gives states more time to adjust. But that still will cause a "massive shift" of financial risk from the federal government to states, health care providers and patients.
Former Arizona Gov. Jan Brewer urged Congress to slow down and find a way to save Medicaid expansion that would be virtually eliminated under a U.S. Senate proposal.
Brewer said the Senate plan released Thursday would harm the state's most vulnerable citizens, including children, seniors and the disabled. And she says cutting Medicaid will cost health care jobs, could force rural hospitals to close and eventually cause private insurance premiums to rise. That's because those losing coverage will still seek treatment in hospital emergency rooms that has to be paid for somehow.
Reaction from Arizona senators
Sens. John McCain and Jeff Flake are so far not saying if they back the new Senate proposal.
McCain said Thursday he's closely reviewing the draft legislation and wanted to speak to Arizonans, including Republican Gov. Doug Ducey, before making a decision. Flake tweeted that he's reviewing the plan and his spokesman would not provide more information on his position.
Arizona Rep. Andy Biggs said the American people demanded a full repeal and the proposal released by the U.S. Senate on Thursday doesn't fulfill that promise.
Biggs, who was formerly president of the Arizona Senate, was among the few Republicans who voted against the House health care bill last month, saying then that it also failed to fully repeal "Obamacare."