Medicaid Expansion Bill

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Governor Jan Brewer has introduced a bill to expand Arizona’s health coverage for the poor to include 300,000 more people. Hear the pros and cons of the idea. Representative John Kavanagh will speak about the cons of the bill.

Ted Simons: Coming up next on "Arizona Horizon," the Governor released a plan to expand Medicaid this week. Now it's up to the legislature to decide if the plan will be implemented. We'll hear from lawmakers on both sides of the issue. Also tonight, how do you measure the value of the arts on society? Those stories next on "Arizona Horizon."

"Arizona Horizon" is made possible by contributions to the Friends of Eight, members of your Arizona PBS station. Thank you.

Ted Simons: Good evening, and welcome to "Arizona Horizon," I'm Ted Simons. Governor Brewer this week announced draft legislation to expand Arizona's health insurance plan for the poor. But the plan needs the legislature's approval and that's far from a done deal. Here to discuss the legislation is Representative Debbie McCune Davis, who is in favor of the bill. And speaking against the Governor's plan is Representative John Kavanagh. Good to have you both here, thanks for joining us. Why is this good for Arizona?

Debbie McCune Davis: We need to restore health care to a group of folks in Arizona. We have a great opportunity with the Affordable Care Act. We have the ability to do what the states around us are doing, and that is to build a system of access to care for everybody in Arizona, and it is -- it's a common sense thing, we simply need to put something in place that allows people to get access to health insurance, that provides access to health care.

Ted Simons: So what's wrong with this plan?

John Kavanagh: First of all, America can't afford this, and Arizona is part of America. This is a budget-busting proposal. In addition, it has grave risks to the Arizona budget. If some of the parts that could fund this collapse, it could expose to us billions in extra expenses. It constitutionality is hardly questionable and there is a better way.

Ted Simons: I want to go back to the idea regarding the state can't afford it and the federal government can't afford it. We had legislative leadership on earlier in the week and that's basically what they said, as well. Take a listen.

Sen. Andy Biggs: What we're asking truly is that we assess and unfairly burden not just today's taxpayers, but generations to come, to pay for what? Current year health care. That's really what it boils down to, 40 cents of every dollar at the federal level is paid for how? It's borrowed.

Andy Tobin: We recognize there's a crisis, we recognize there's an emergency room problem, we recognize there's an uninsured problem out there. The question is, do you end up moving forward on billions of dollars and federal dollars that don't exist coming to Arizona, and that's really where the debate is.

Ted Simons: That indeed is where the debate. You heard Representative Kavanagh say the federal government can't be counted on to cooperate here.

Debbie McCune Davis: I'm going to go back 20 years to when Arizona adopted the Medicaid or access plan. The federal government stepped up and they have been at the table with money every year since. I think they have been a reliable partner and I think they will be going forward. The idea of the Affordable Care Act going forward is to really improve the situation nationally, and to try to bring the cost of health care down while creating access for all. The idea that we can't afford it has to be counter posed with the question of, can we afford not to do this. We have obligations to meet and this is one of the areas Arizona has to step up.

Ted Simons: We've heard about this unintended tax, the uncompensated care tax. The question does remain, if this doesn't pass, doesn't happen, can we afford it?

John Kavanagh: The federal government runs a yearly deficit of $1.1 trillion dollars. The federal debt is approaching $17 trillion dollars. You add the unfunded liabilities the federal government has dollars to Social Security, Medicare, and federal tensions, the total government debt is 88.6 trillion dollars that's over 500% GDP. We are on the road to Greece. This type of irresponsible spending cannot go on. We will be a third-tier country.

Ted Simons: Is not a circuit-breaker, as the governor calls it.. whereas if the government gets below the 8-% agreed-to line there --

There is a circuit break for Arizona, but it's the federal government that's paying for all of that, that's how they are getting us in. The federal government is broke, they can't afford this wild spending. As to Arizona there are problems here too. It the match goes down to 80%, even with the circuit breaker, that adds $225 million to our budget down the road. If infact the bed tax, which the Simpson-Bowles budget reduction commission characterizes as a gimmick, used to draw down money, and it is a gimmick. they get rid of this because it will save the government $44 billion a year, if the Feds wake up and realize to start saving money, and they get rid of this bed tax, we will be responsible for the federal match if we pass this bill. That's $1.6 billion a year. It will bust our budget wide open.

Ted Simons: Respond please.

Debbie McCune Davis: I find myself in a very funny position, taking the Governor's side over what is essentially a fight within the Republican caucus. There are Republicans who know what's going on in the economy in Arizona, who know since the cuts have been made to health care in Arizona and the Prop 204 population frozen, there is a direct correlation between the number of people taken off healthcare and the issue of uncompensated health care in our hospitals. The issue is relevant where we are today, not down the road.

John Kavanagh: The hospitals are not making profits as large as they were in the past. They just gave Betsy Bayless, the administrator of our poverty hospital, a salary bump to $500,000 a year. There's plenty of money, it's the federal government which hasn't got the money. Beyond that, this program adds 400,000 people to the existing 1.2 million people in Arizona to indigent health care. What is that going to do a doctor visits and hospital care? Can you throw that many people into a health care system and not totally overburden and overwhelm it? I don't think so.

Ted Simons: What do you make of that?

Debbie McCune Davis: Well, it's an overstatement. This is access to care. It doesn't put people in doctors' offices. It gives them access to preventative care and to serves when they need it. When they are sick they seek it out. The question is, are the providers providing the care being paid it for, or are we putting the burden on the community? What we did with the 204 population essentially shifts the costs to our community partners.

Ted Simons: The Governor says the Republican Party will be blamed if these people lose coverage and the people that could be getting coverage are left on the streets, left to their own. The Republicans seem to feel otherwise. This is quite a split in the Republican Party, but does she have a point? If folks wind up saying, wait a minute, where's my coverage, they will be looking at you.

We're not talking about losing coverage. We're talking about not expanding to 133 percent--

There will be some who lose coverage come January 1st.

John Kavanagh: Nobody will lose coverage The only program that's frozen are the adult -- childless adults, and our proposal is to maintain the status quo and reform health care so it'll be affordable.

Ted Simons: No one will be thrown off?

Debbie McCune Davis: Yes, because they have already been thrown off to a substantial degree. What will happen is, as we move into the new year, and we don't come online with Medicaid alignment expansion, whatever you want to call it, the amount that the federal government matches the state dollars will change, and there will be a burden. And the folks who are opposing this for the most part would like to see us deliver health services to less people. So I think it moves in the direction of those who simply want to eliminate the program.

Ted Simons: Back to leadership we had on earlier in the week. Speaker Tobin talked about the fact that there are a lot of folks debating the issue. He's worried that no one seems to be speaking for the taxpayers.

Andy Tobin: We already know the folks who need to get the benefits have a place at the table. Where's the place for the folks paying all the bills? I think in my caucus they are starting to say, well, yeah, what's happening to the taxpayer?

Ted Simons: Legitimate question there, what's happening to the taxpayer?

Debbie McCune Davis: I think the Governor makes the case which she says, do the math. She suggests when the state puts in the number of dollars raised through the assessment, that's matched on a 10-1 basis with the federal match, where you go with that jobs, better services and boost to the economy. I think that's where the taxpayers make out.

Ted Simons: Most efficient way to meet Arizona's medical needs, that's how this is described, especially with all those matching funds. Are they wrong?

John Kavanagh: The most efficient way is tort reform, to give people levels of insurance policies with different benefits. The most efficient way is to lower rates through nationwide benefits. The most efficient way is to have co-pays to discourage people from unnecessarily going to the doctors. That's the free market method that made this country great. This is a massive socialized Medicare Obama-care schema. The health care is unsustainable, you can't even get half of the doctors, one-third third of the doctors wouldn't take the patients because the payments are terrible. It's destroying the health care system and we're printing money and borrowing from China to pay for this disaster.

Ted Simons: Free market makes better sense than this?

Debbie McCune Davis: I think Mr. Kavanagh's statements are overstatements at best. First of all, Arizona's Medicaid system is done through a public-private partnership. We have privatized it, it's working well and it's recognized across the country. The concept of a free market doesn't work with an aging population. You cannot find underwriters who are going to take the older population and give them a fair shake, terms with coverage. The bottom line is that's just rhetoric. We're in Arizona today, we have to address Arizona's problems and we have a solution available.

John Kavanagh: Using that reasoning, public welfare is a private thing. When they get the public money, they spend it in private stores. This is public money with a massive take over with a large segment of our economy. It's overcrowding everything.

Ted Simons: Before we go, we had ASU President Michael Crow on the program. He came out with a statement on this, interestingly. He basically said this is the right thing to do right now.

Michael Crow: The core value that everybody should have access to health and happiness and advancement and social mobility. And these are -- investments that are configured in this particular strategy help that to occur for the foreseeable future. There may be better ways to finance it in the long run, but we're not at the long run yet. This is the way to do it right now.

Ted Simons: We can debate ideology all we want, but when you talk about matching funds and the needs of hospitals and patients and an aging population, the whole nine yards, this makes the best sense.

John Kavanagh: It makes no sense. Older people are on Medicare and nobody's touching Medicare whatsoever. The salutation is tort reform, so you don't have expensive lawsuits and defensive medicine. More insurance plan choice, Obama-care says everyone gets a platinum policy. You can have cheaper policies that cover less things. More competition, copays, let people do tax deductions. That's the solution that works for America. This is the wrong way and it's bankrupting this country and making my grandchild pay the debts of today. That's bad.

Ted Simons: Final word.

Debbie McCune Davis: I hear from constituents who have medical treatments that they need today. We have to offer them a solution. So far we've put some freezes on programs and we've told them that they basically have to take care of themselves. Medicaid eligibility at 100% of federal poverty, under 204 is $15,000 a year. If you have exceptional medical bills, you will not get treated in this state. You will not find access to treatment. That's what we're trying to fix.

Ted Simons: We need to stop it right there. Good discussion, good to have you both here. Thanks for joining us.

John Kavanagh: Thank you.

John Kavanagh:Representative;Debbie McCune Davis:Representative;

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