As the federal government moves closer to repealing and replacing Obamacare, states such as Arizona that accepted Medicaid expansion funding worry they may be left holding the bag if the funding stream slows to a trickle.
Nearly 2 million people are enrolled in Medicaid in Arizona with more than 400,000 signing up since the Republican-led state expansion of Medicaid in 2013.
It is unclear how much the U.S. Congress will ultimately cut from the program; however, some believe it could hurt the most vulnerable in society including those who are developmentally disabled and special education children.
The House version of the American Health Care Act proposes to cut up to $880 billion from Medicaid over 10 years, which could have a debilitating effect on caring for and educating children with special needs.
Although State Rep. Regina Cobb, R-Kingman, hasn’t looked at the House proposal to replace Obamacare in its entirety, she realizes at times there are excessive decisions made at the federal level that trigger financial consequences to the states.
“Special education isn’t an area that I usually like to make cuts to,” Cobb said. “There are probably some specifics that we don’t know about, but it is probably right that the state is going to be picking up the tab if we end up keeping special education in at the state level.”
State officials fear they may see a self-fulfilling prophecy happen if Medicaid funding is tamped down as they become responsible to provide the majority of services.
“I’ve worked with the governor’s office during the past year looking at different scenarios and what would happen,” Cobb said. “Over the summer, we will look at the different scenarios and see how we can shuck and jive in a certain direction once things get moving. It’s going to be a difficult next couple of years with some of the cuts that are being proposed.”
Though there are unknowns on how the federal government will fund Medicaid and by how much, cuts to the program could also cause unintended consequences, Cobb said.
“We don’t see all of the ramifications of everything that we do,” she said. “This could create ramifications that we have to deal with much like with Proposition 206 where we didn’t see what the end result would be to our developmentally disabled community and school districts as well.
“We saw education budgets increase as a result. Everything we do has a trickledown effect and special education is not an area that you can cut.”
Approximately 46 percent of Medicaid beneficiaries are children with 20 percent of the program’s funding going toward the care of this population.