This piece ran in the Arizona Daily Star on December 15, 2016
As members of Congress plan to make good on their campaign promise to repeal the Affordable Care Act (ACA), several hundred thousand Arizonans wait and watch with concern about how they will meet their families’ future healthcare needs. Additionally, Arizona policymakers are ringing the alarm bell raising concerns about potential damage to our state’s economy and the detrimental effects on future state budgets if repeal takes place without sensible replacement.
This sounding alarm cuts across party lines with good reason. The fallout from repeal could negatively impact hundreds of thousands of Arizonans and their families as well as blow up our state budget and take a Grand Canyon sized bite out of Arizona’s economy.
According to AHCCCS, the agency that administers our state Medicaid program, repeal without replacement could remove health-care coverage from 425,338 Arizonans. In addition to this loss of coverage, the cost of providing health care to the remaining AHCCCS participants would increase by $328 million per year — money that currently comes from the federal government via the ACA.
It’s no surprise that Arizona Republican leaders are just as concerned as Democrats.
Gov. Doug Ducey recently told the media that he wanted to ensure that federal Medicaid dollars continue to flow into Arizona. “I am not talking about repeal,” he said. “I’m talking about repeal and replace,” Ducey explained. “I want to see all of our citizens have access to health care that’s affordable.”
Former Gov. Jan Brewer also indicated that she wished to see Medicaid expansion in Arizona stay in place. In 2013 lawmakers in Arizona reinstated Medicaid coverage for individuals at up to 138 percent of federal poverty level using federal funds made available to the state through the ACA. Before 2013, Medicaid coverage was available only to individuals up to 100 percent of the federal poverty level.
What would a repeal of the Affordable Care Act mean for Arizona?
Repeal would reverse Medicaid expansion eliminating Medicaid coverage for over 425,000 Arizonans (those who fall between 101 percent to 138 percent of the federal poverty level). Tied to this elimination of coverage is the loss of $328 million federal dollars from the general fund annually and an associated $3.2 billion hit to Arizona’s economy.
In our current budget situation, having to come up with $328 million to replace the federal funding loss endangers our schools and universities.
It is obvious Arizona simply cannot afford the cost associated with a repeal of the ACA without a meaningful replacement that maintains our current Medicaid coverage and includes the insurance reforms that many Americans agree are necessary. These reforms include a ban on denial for pre-existing conditions, removal of lifetime spending caps, and allowing young adults to stay on their parent’s plan until age 26.
As a physician I know how important coverage is for families when a medical disaster strikes. Without health-care coverage, working families may put off needed treatments, allowing easily reversible medical issues to escalate into illnesses incurring extra costs and requiring additional resources to resolve.
Arizona hospitals will not turn away those in need of emergency care. For that reason, a repeal of the ACA will result in a marked increase in uninsured Arizonans, causing health-care costs to rise as uncompensated care skyrockets.
Lawmakers need to ensure that the paths of politics and policy intersect. Straight-up repeal of the ACA in the absence of a sensible plan for replacement is pure politics. Good policy demands replacement before repeal, or no repeal at all.
Politics may get politicians elected, but it’s the creation and implementation of sound policies that provide their constituents with the opportunity to lead healthy and productive lives.