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home : opinion : columns May 25, 2016


4/16/2013 6:00:00 AM
Column: AZ Medicaid expansion unsustainable
Dr. Kelli Ward
State Senator

Since January, many of us at the State Capitol have been trying to determine a common sense way to approach reliable health care for our neediest citizens. It is clear that a full expansion of our Medicaid program to 138 percent above the federal poverty level (FPL) will add 400,000 patients or more to an already overloaded system.

After carefully studying this complex issue, I have determined the plan is unsustainable and potentially harmful to hardworking Arizona taxpayers. We simply do not have the doctors and other health care providers to offer primary care to these new patients.

When people are sick or seek care for their chronic illnesses, they will not be able to get into a doctor's office, so they will instead turn to our emergency departments. Not only will that be much more expensive to Arizonans, but the people are unlikely to get the kind of care they need most.

The last time we expanded AHCCCS (the Arizona Health Care Cost Containment System - AZ's Medicaid), we grossly underestimated the number of people who would enroll. Three times more parents of Medicaid-covered children and two times as many childless adults signed up. Costs went from an estimated $315 million to an actual $1.2 billion.

Voters were told tobacco settlement money under Prop 204 would cover the added patients, but quickly we had to dig into the general fund.

Now we are being told a hospital bed tax will cover this expansion proposal and the federal government will bear the burden of the majority of the costs until 2017. Remember, the federal government gets its money from us - the taxpayers. While no one can predict the true future price tag, experience proves that the costs have always been much higher than estimated.

Do not let people tell you there are no alternatives and we either expand or do nothing - there are real options.

We should request that HHS allow Arizona to continue our current plan for those under 100 percent of the FPL and for Arizona to determine the best way to provide care for our indigent population.

We should find ways to complete treatment of Medicaid patients who are in the midst of potentially lifesaving therapy for catastrophic illnesses despite the expiration of our current federal waiver on Dec. 31, 2013. We can find a way to make an exception for this small number of patients.

People above 100 percent of the FPL who are not otherwise eligible for coverage are able to buy subsidized policies through the federal exchange, and we should let them.

We should consider providing catastrophic coverage policies for those under 100 percent of the federal poverty level and a graduated plan for other services. Cost transparency should be our goal.

And we must seek tort reform to discourage the practice of defensive medicine which drives up the cost of health care.

Our Medicaid system in Arizona is one of the best in the country, but I don't believe that we need to make it bigger and give control of the hundreds of millions of dollars to an unelected agency director. I will continue to seek free market solutions to our health care dilemma and find ways to care for those who are unable to care for themselves.

If you only remember one thing, remember this: the Medicaid expansion plan is about increasing the entitlement to health care coverage without any guarantees of increased accountability, improved access to care, higher quality, or lower costs of health care - it is a step in the direction of socialized medicine and much bigger government.



Senator Kelli Ward, D.O., MPH is a family physician with additional expertise in health policy. She represents Arizona's 5th Legislative District and resides in Lake Havasu City with her family. She serves on the Senate Health & Human Services (vice chair), Appropriations, Education and Government & Environment committees.

Related Stories:
• State Column: State needs federal Medicaid partner


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Reader Comments

Posted: Thursday, April 25, 2013
Article comment by: Anson's Nephew

Jeffie

“No you haven't. Besides it doesn matter if you did or didn't.”

I have read the entire bill.


Posted: Wednesday, April 24, 2013
Article comment by: Dean Wolslagel

Doctors should start really worring about caring rather than money issues. We need doctors at hospitals and other facilities not in the middle of the political crap. Look back at the last 25 years of reducing government programs for the 99% and look at what going on in the big cities with crime . Crime is a symptom of a bigger problem... people are loosing faith in the American dream. What ever happened to the USA that cares for the elderly and the needy ? It appears the leadership of the GOP is a puppet for the extreme weatlhy who want no social programs at all.

Posted: Thursday, April 18, 2013
Article comment by: Jeff Stoneberger

@Anson's Nephew...

"As I have stated many times I have read the entire ACA"

No you haven't. Besides it doesn matter if you did or didn't. The fact is, the fool in DC that passed it, didn't read it. They don't even know whats in it.
Its going to fun watching Obamacare implode the next few years. But its also sad that many people will be hurt during that time as well because of it.

And I can't wait till the Hobby Lobby vs Obamacare reaches the Supreme Court. I can't see SCOTUS screwing up twice on Obamacare. Or can I?


Posted: Thursday, April 18, 2013
Article comment by: Anson's Nephew

Ms Smith

“Kelli Ward is correct in her assesment of OB care.”

Nope, she is simply spewing what her lobbyist master have told her to say – remember she “loves lobbyists.”

“The total bill is approximately 213000 pages .”

Still wrong.

“Everyone will be receiving a Stack of paper work which is required to be filled out and returned.”

And you know this because ….. oh wait, you are wrong again!


Posted: Thursday, April 18, 2013
Article comment by: Anson's Nephew

Ms Athens

“What a breath of fresh air Dr. Ward is. Thank God we have her representing us.”

She is like a breeze wafting across a sewer pond and it was not God who cursed us with Ron Gould Lite.

“So Bob Moore read the whole obamacare bill. Hahahahaha! Sure he did.”

Yes I did and I have read many of the supplemental pages to the bill and still I cannot find a single of the things you claim is in the bill. Perhaps before ranting you should actually read it. Oh wait you “don’t have the time” and yet you “have the time” to show up here day in and day out posting nonsense.

“Obama could not even manage four people at Benghazi.”

So now the “management” of people assigned to embassies and consulates is the responsibility of the president? Where do you get this nonsense? Oh that’s right Goofy Beck and the Drug Addict are your sources of information along with chain e-mails and FAUX News. Pathetic.


Posted: Thursday, April 18, 2013
Article comment by: Amaryllis Smith

Kelli Ward is correct in her assesment of OB care. The total bill is approximately 213000 pages . It is geared to become socialized medicine
Everyone will be receiving a Stack of paper work which is required to be filled out and returned.
It will cause many thousands to have to seek out yet more newly hired "Negotiator" to help do that and guide people through the process of chosing a plan. That plan one ends up with will be determined on a huge number of factors.
These negitiators will have no requirement of any type related to medical background.
The number of forms you receive will depend on what category someone extemely remote from you will decide.
OBC is what is unsustainable for all concerned and a disastor for this nation as a whole.

Mr. Moore I am quiet positive you have not read the entire OBC bill as in the entirety it does stand over 7 feet tall and consist more closely of 213,000 pages! It is FULL of regulations and taxes that will ultimately destroy any semblence of this nation as free enterpise!


Posted: Thursday, April 18, 2013
Article comment by: Az worker

Lady, I have worked in Az for over forty years. I am on social security and can't hardly pay for my meds now. No I'm not on Medicare and don't qualifiy for Medicad. So I sit here and suffer so you people can decide what I can and can't do or when to pull the plug on me. One day I hope you are in our position, then you will see what is happening. I paid my taxes for forty years now I can't get a little help,KIS THIS!!!!!!!!!

Posted: Wednesday, April 17, 2013
Article comment by: Linda Athens

What a breath of fresh air Dr. Ward is. Thank God we have her representing us.

So Bob Moore read the whole obamacare bill. Hahahahaha! Sure he did. How about the 12,000 additional pages - actually since the story I will post below, I believe it is now 14,000. That would be the reason a Democrat testified today to the HHS that obamacare is a disaster that noone can understand, will be a nightmare to try to implement and basically, is undoable. Good for him. Dems coming around.

>>>docs4patientcare.com -

Galen Institute's Grace-Marie Turner's latest column at National Review Online discussed the three scenarios for how the Supreme Court will decide the multi-state lawsuit challenging ObamaCare's individual mandate and the laws burdensome Medicaid requirements. Her article also contains a very disturbing fact.

She writes:

Meanwhile, the health sector and overall economy will be forced to start answering to the 159 new agencies, programs, and bureaucracies authorized under Obamacare and complying with the 12,000 pages — and counting — of new regulations. The burden of costly mandates on businesses will kill any hopes of job recovery. And the law’s perverse incentives for employers to drop insurance will likely toss tens of millions more people into taxpayer-subsidized coverage, destroying any chances of getting the federal budget deficit under control. The legislative and legal battles over the unpopular law will go on and on.

The 12,000 pages of new regulations work together to undermine the rights of doctors and the ability of patients to receive care consistent with the patient's best interest.<<<<

159 NEW AGENCIES. Just what we need. More government agencies which means more government waste. lousy management like most govt agencies. Obama could not even manage four people at Benghazi. Can you only imagine this nightmare?


Posted: Wednesday, April 17, 2013
Article comment by: anonymous anonymous

The real irony here is the main argument the anti-health care folks use is doctors will quit being doctors, nurses will quit being nurses, the only thing that might disappear is them vampire medical insurance companies whom might be replaced by a system where one cannot charge $5 for a single asprin, where a doctor does not become a billionaire or nurses become millionaires! I remember a funny story in the Ponzi scheme thing a nurse lost her retirement savings $7 million dollars and was sad she had to live on her social security! Folks who want the status quo profiteer from the sick, elderly in one way or the other either a direct way or via a relative! If not benefiting and advocating this the are as dumb as a stump!

Posted: Wednesday, April 17, 2013
Article comment by: RoseMarie Lesniewski

Every industrialized nation has national health care except the United States. Why is this??? Because the lobbyist and rich will not allow it. Our Government is controlled by Big Business and Lobbyist that work for them. Obama Care doesn't go far enough. We should have a single payer, or everyone should be on Medicare even our officials. Then things would change. We know that is not going to happen if the Tea Party had its way we would have no health care, Medicaid or Medicare.

Posted: Wednesday, April 17, 2013
Article comment by: Anson's Nephew

Gal

“Now I wonder if I will be given a # 99 number?”

Please fill us in on the “99 number”? What is it? Be specific, please. Thank you



Posted: Wednesday, April 17, 2013
Article comment by: Anson's Nephew

“How many of you that are against what the Senator wrote have actually read the 20,000 pages of the Obamacre law?”

As I have stated many times I have read the entire ACA (and BTW it is n0ot “20,000 pages) and the garbage put forth by Ms ward is what her masters – the insurance lobbyists – have demanded of her.


Posted: Wednesday, April 17, 2013
Article comment by: kgmn gal

Yesterday, I received a survey from MEDICARE regarding my health status, how I pay my medical bills, what medications I use, helps that I receive etc..
Now I wonder if I will be given a # 99 number? a 99 number be that I will be one of those who require too much help, have too many medical problems etc.. and thus, in some fashion I am placed on the 99 list... Remember Solyant Green.. ? I will be placed in a deep sleep and let pass on......................

this is scarry... I as so many other seniors suffer from a multitude of medical problems and our incomes are limited... frozen... at a given amount. I am frightened! by what is going on with Medicare, medicad (ACCCHS), insurances.


Posted: Wednesday, April 17, 2013
Article comment by: anonymous anonymous

As long as the medical community has their lap dogs in powerful and controlling positions they will continue to try to maintain the status quo! The fact this doctor turned politician says the only option is to let the sick go to emergency rooms for treatment as if no one is going to pay the tab we will see the same old status quo! Borrowing from Peter to pay Paul is what she is suggesting, thing is both are the tax payers in the end, reminds me of the old shell and peanut game con guessing which shell the peanut is hidden under!

Posted: Tuesday, April 16, 2013
Article comment by: Gisela Potokar

How many of you that are against what the Senator wrote have actually read the 20,000 pages of the Obamacre law?

New laws made up everyday! It is crippling our country's growth.


Posted: Tuesday, April 16, 2013
Article comment by: anonymous anonymous

Doctors, nurses, hospitals, medical insurance companies want the status quo to remain, they are making out like bandits getting into that coveted 2% category, one cannot blame the greedy for being greedy, its in their natures like a leopard cannot change its spots the medical community has had this status quo mentality for decades! But its coming to a end, and they can help get elected such pawns as this lady doctor who has a biased view since she has profiteered from the status quo one cannot expect nothing but her to see the status quo as ok, but her and her ilk days of sucking the life blood from the sick, elderly is coming to a end!

Posted: Tuesday, April 16, 2013
Article comment by: Sophie McClare

This editorial is rather non-sensical. Claiming that a shortage of doctors will send people to the emergency room is reasonable, but why does that equate to not treating them at all? Is the answer just to let the hospitals pick up the bill and pass it along to other patients (as they are already doing)?

Sometimes, I think Senator Ward is too blinded by politics to use her brain.

We simply do not have the doctors and other health care providers to offer primary care to these new patients.

When people are sick or seek care for their chronic illnesses, they will not be able to get into a doctor's office, so they will instead turn to our emergency departments. Not only will that be much more expensive to Arizonans, but the people are unlikely to get the kind of care they need most.


Posted: Tuesday, April 16, 2013
Article comment by: Al K

"Senator Kelli Ward, D.O., ----- with additional expertise in health policy."

With All due respect Dr, I must question your so called expertise. This country, which includes Arizona, has a health care problem. Medicaid (and Medicare) is a part of this problem, granted a large part, but still a part of the bigger problem. Long before Obama was elected, those with real expertise were pointing out that health care as such was un-sustainable. ACA (aka Obamacare) is an attempt to fix the health care problem. And I don't think anyone, including the President, knows what the results will be. And personally, I think your approach to solve the problem is the worst possible.

So what is the answer? What you fear the most, a single payer system which you refer to as socialized medicine. You know, like the single payer system that you and your husband are covered under called tri-care.

Hypocrite?


Posted: Tuesday, April 16, 2013
Article comment by: Trained Observer

@ We simply do not have the doctors and other health care providers to offer primary care to these new patients.

These "new patients" didn't miraculously rise up out of the dirt. They have been here all along.

As with most "Republican logic", it's "just say no" which solves nothing. Determining that is doesn't work won't solve the problem. Fix it so it does work and get off the "let them eat cake" attitude.


Posted: Tuesday, April 16, 2013
Article comment by: J J

So let me summarize: "I can't do anything to change this, but I'll be sure to use talking points like "hardworking citizens" to stir up my base and make them think I can actually make a difference." Oh, and "it's Obama's fault."

That about cover it?


Posted: Tuesday, April 16, 2013
Article comment by: Frances Perkins

Who wrote this for your Kelli? The Goldwater Institute or ALEC? And just what other additional expertise in health care policy are you citing? Your attendance at Goldwater or ALEC briefings and seminars? Do you and your husband provide health care insurance to your employees? You have been bashing this Health Care Reform bill since you were putting up your campaign signs in illegal locations. It is really Romney Care dressed up, you should be in favor. This Country spends more on health care than any country on earth, per capita. We get poorer outcomes. Even your Goldwater buddies say hospitals and doctors get money out of proportion to what they do or what their costs are. And your governor vetoed a bill that would have required doctors and hospitals to post prices for the most common procedures, but of course, y'all don't want to disclose prices, since they change all the time based on who pays.

Posted: Tuesday, April 16, 2013
Article comment by: Still Here

Maybe the State of AZ should stop throwing away so much money on the Jodi Arias trial and use the million plus to help those in need.

Posted: Tuesday, April 16, 2013
Article comment by: Anson's Nephew

“After carefully studying this complex issue, I have determined the plan is unsustainable and potentially harmful to hardworking Arizona taxpayers.”

And of course the program cuts into the “take home pay” of Ms Ward and her husband.

“And we must seek tort reform to discourage the practice of defensive medicine which drives up the cost of health care.”

Ahh, and there is the standard meme of the insurance lobby, and remember Ms ward has already told us how much she “loves” lobbyists. Tort reform is a scam designed to protect the insurance industry and incompetent physicians. Think back to the “no fault car insurance” the insurance industry foisted off on us as a way to lower insurance costs. How’d that work out for you?

“… it is a step in the direction of socialized medicine and much bigger government.”

Translation – it’s going to cut into my bottom line.

Ms Ward, as usual, is bad for Arizona and bad for Arizonans.




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