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Medicaid and abortion: It’s a key issue

Fri May 17, 2013 5:31 PM

The proposed Medicaid expansion means significant amounts of public money will go to abortion providers. Supporters of expansion say this is a negligible amount and no big deal. They point out that federal law already prohibits tax dollars from directly funding abortions, which would seem to settle the issue.

Except that it doesn’t.

The Medicaid framework does not give Arizona the ability to exclude taxpayer dollars from going to abortion providers. In fact, the Obama administration is taking each state to court that attempts to reserve Medicaid resources for health care but not elective abortions. That’s what happened here.

Last year, a federal judge agreed with the Obama administration and blocked an Arizona law preventing abortion providers from participating in Medicaid. That ruling is on appeal and may take years to resolve. In the meantime, Arizona and the rest of the country must live with the Obama administration’s agenda of using Medicaid to fund the abortion industry.

We can lock Arizona into a top-down health-care system, where nearly everything turns on federal approval. Or we can come up with an Arizona solution.

Expansion supporters say AHCCCS is the nationally recognized gold standard for cost-effective managed care. If so, we should be willing to place ourselves at the Legislature and state workers onto plans with the same benefits and restrictions. By reducing the spending on health care per person to Arizona Health Care Cost Containment System levels, we would save more than $100 million per year in the state general fund.

The federal government just approved a one-year Phoenix hospital bed tax that can make an additional $200 million available to the state’s general fund this year. This, coupled with Gov. Jan Brewer’s hospital bed tax, gets us to more than $800 million over three years.

By giving elected officials and government workers the same insurance as hardworking Arizonans, we can restore the Proposition 204 population to AHCCCS on our own. (In 2000, voters approved Prop. 204 to broaden AHCCCS eligibility to everyone under 100 percent of the federal poverty level.)

More broadly, Arizona needs to consider a high-risk pool for the small number of people who might otherwise fall through the cracks in the system. By increasing transparency in pricing, in how hospitals actually report uncompensated care, and in lawsuits, we will save real money for hardworking Arizonans.

We should also boost health-savings accounts that roll over any unspent money. We need to be very wary of coverage mandates, which can significantly raise prices. Last, we should restructure AHCCCS so that members share some, even a small, responsibility for costs.

Collectively, these ideas can achieve the same outcome of protecting our health care and all other legislative priorities. We ought to consider them before we rush into more regulations, less freedom and uncertainty if the money will be there.

Let’s take the time to get this right.

The U.S. Supreme Court gave Arizona an opportunity to avoid the heavy federal hand that comes with expanding Medicaid. If we reject that opportunity and sign on to Medicaid expansion, we may be losing our best chance to formulate a health-care system that makes sense for Arizona.

Republican state Rep. Paul Boyer, vice chairman of the House Health Committee, represents Legislative District 20 in Phoenix.

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