Comment period for proposed Arizona Medicaid co-pays, other changes, extended

Although the state’s public comment period on a controversial proposal to change how Arizona runs its Medicaid program has closed, a federal comment period has been extended through Dec. 6.

The proposal, which critics say is harmful to the poor, could make Arizona the first state in the country to impose lifetime limits of five years on Medicaid enrollment. The federal comment period was supposed to close Monday, but the U.S. Centers for Medicare and Medicaid Services (CMS) has extended it. Individuals and organizations are invited to comment.

The proposal is important because whatever the federal government approves determines how Arizona’s Medicaid program will operate in the future.

The state’s Medicaid program, called the Arizona Health Care Cost Containment System (AHCCCS), is for low-income residents. The threshold is a yearly income of 133 percent of the federal poverty level or less — that’s $31,721 or less for a family of four and $15,521 or less for an individual.

Arizona’s application for changes to its Medicaid program includes imposing copayments and premiums on certain enrollees, eliminating non-emergency transportation coverage for people earning more than 100 percent of the federal poverty level, and imposing a five-year lifetime enrollment limit on “able-bodied” Arizonans over the age of 18. The lifetime limits would not apply to Arizonans who have jobs.

The requested overhaul of the program, which requires federal approval, is a combination of changes by both Gov. Doug Ducey and the Legislature. A federal decision is expected by Oct.   1, 2016. Any changes in the overhaul would occur after that.

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Ducey and other supporters of the plan describe the reforms as a much-needed way for Arizonans to take more responsibility for their own health, get more involved in their own healthcare, and to ensure Medicaid is a temporary option for Arizonans — more like a bridge to independence than a permanent solution.

Medicaid was originally designed to serve children, pregnant women, the elderly and people with disabilities, Ducey wrote in the application letter to U.S. Department of Health and Human Services Secretary Sylvia Burwell.

But the program now serves nearly as many adults as it does people in those traditional categories, he wrote. More than one-quarter of all Arizona residents are now enrolled in AHCCCS, with 1.8 million enrollees, including 280,284 in Pima County.

U.S. Rep. Raul Grijalva, a Democrat from Tucson who has been critical of the public’s ability to be part of the overhaul, praised CMS for extending the federal comment period.

“This is critically needed given the fact the state formed this proposal behind closed doors, did not allow the public to see the full application before it was submitted and did not conduct proper consultation with our tribal communities,” Grijalva said in a news release.

The state held five public forums, including one in Tucson that was held at Casino del Sol southwest of Tucson during the Sun Tran bus strike. The state also accepted public comments via email and regular mail through Oct. 12.