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May 5th, 2011
Reps. Grijalva, Pastor Send Letter to CMS Urging Rejection of Arizona Request to Freeze Medicaid Enrollment, Slash Benefit Rolls

Washington, D.C.– Arizona Reps. Raúl M. Grijalva and Ed Pastor today sent a letter to the Center for Medicare and Medicaid Services (CMS) urging the agency to deny Arizona’s request to freeze enrollment in the state’s Medicaid program and slash existing benefit rolls. The issues raised in the letter could have national implications, especially as other states consider making similar requests.

As the letter points out, a combined 70,000 Arizonans join and leave the Arizona Health Care Cost Containment System (AHCCCS) each month, and freezing enrollment would effectively eliminate Medicaid services to hundreds of thousands of people statewide. The letter cites several pressing legal and economic issues raised by the state’s request, including its violation of the Affordable Care Act’s mandate that states meet a so-called maintenance of effort requirement barring reductions in Medicaid benefits.

As the letter says, “To slash this vital program in times of economic challenges would be irresponsible as it will further devastate our economy and could create a public health crisis. The decisions made now will set precedent for Medicaid programs  across our nation. Thus, it must be made clear that the intent of Congress will be carried out and that the objectives of the Medicaid program will be upheld.”

The state is seeking not only to cut existing rolls, but to be allowed to manage aspects of the program in perpetuity based on its own estimation of how to use “available funds.” The letter asks why the Secretary of Health and Human Services should grant unprecedented authority to reduce the program’s scope in future years without federal oversight.

The letter lists several features of the plan that concern Grijalva and Pastor, including:

§  Effectively eliminating the childless adult coverage program

§  Freezing enrollment by certain parents

§  Creating a more burdensome AHCCCS renewal process

§  Establishing mandatory co-payments for children and adults

§  Eliminating certain emergency services

§  Creating penalties for missed appointments

§  Eliminating non-emergency medical transportation

The letter cites numerous reasons CMS should reject the state’s request, including likely economic damage and job losses; violations of federal law, including the ACA and the objectives of the Medicaid Act and Social Security Act; failure to comply with federal cost-sharing project criteria; setting unprecedented limitations on the Secretary of Health and Human Services’ future authority; a lack of necessary public comment during consideration of the proposal; and a lack of consideration of alternative proposals.

“Freezing Arizonans out of the state health care system doesn’t magically reduce costs – it just passes the buck and ensures that working families don’t get the care they need,” Grijalva said. “This plan is just obviously not going to work. There’s no reason for CMS to allow it to go forward, and I hope for our state’s sake that they make the right decision.”

The proposed changes to our Medicaid program are unworkable and irresponsible,” Pastor said. “If the proposed plan is approved, thousands of Arizonans would be forced to go without medical coverage while taxpayers and hospitals are left to foot the bill.  The state’s plan would lead a potential public health crisis which Arizona can’t afford.”

As the letter highlights, the state legislature and Gov. Jan Brewer approved a large state tax cut package earlier this year even as they attempted to slash AHCCCS on fiscal responsibility grounds. On Feb. 16 the state legislature passed a package of tax cutsthat the Joint Legislative Budget Committee estimated would cost the state $538 million. The package includes a nearly 30 percent reduction in corporate income taxes and allows multi-state firms that sell most or all of their goods outside Arizona to escape paying state corporate income taxes.

The letter is available at /sites/ or at

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