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Arizona Healthcare Conundrum, But There Is a Better Way

Earlier this month, Arizona's legislature passed a budget that would eliminate health care coverage for 47,000 kids by June 15 (310,000 low-income adult Arizonans would lose their health insurance coverage in January).

I wrote a few weeks ago - shortly after the Governor released her budget, which proposed the deep cuts - about the long-term, economy-wide impacts that the Arizona healthcare budget cuts would have. 

But Arizona's Medicaid program, AHCCCS, was dramatically expanded fairly recently (in 2000 through Prop. 204).  So some people argue, "Arizonans were fine in 1999; let's just go back to the way things were then."  Yet there are two problems with that argument:

  • First, a significant amount of economic activity in Arizona's health care system - including tens of thousands of new jobs - developed around that increased funding.  Taking away the funding would leave many of those currently-employed health care workers without jobs. 
  • Second, we're in the midst of the worst recession since the Great Depression - a really cruel time to take health care away from low-income Arizonans.  This would also force many without the ability to pay to seek treatment from already over-burdened hospital emergency departments - increasing healthcare costs for all of us.

For those important reasons, then, I was relieved last week when President Obama signed into law the national health care reform bill, which would require states to maintain current levels of health care funding (so no cuts as Governor Brewer proposed and the legislature passed them).  And Attorney General Terry Goddard announced that he would not be joining other states in challenging the constitutionality of the health care reform bill.

But I was relieved too soon.  Governor Brewer and the legislature have announced that they will fight the federal bill, with or without Goddard.

On one hand, the federal health care reform bill does what a lot of federal laws do - it gives the states a mandate with no help in funding that mandate (at least not immediately, in the case of the health care reform bill).  So now the legislature is largely back where they started, with an absolutely enormous budget deficit and not a lot more available spending-cut options.

So I feel the pain of our state's lawmakers.  But hey, no one said the job was going to be easy.  And, there's another way to work toward a resolution for the huge budget deficit that the legislature should consider. 

As an advocate for investors in Arizona, I believe strongly in the principle that government should tax its people only to provide the services that the government is best at providing (like infrastructure and vital services for the poor who would not otherwise have them).  Beyond that, the government should get out of the way. 

But this really is no time for ideological debates about the role of government.  As one budget advisor has put it, "The house is on fire. Now isn't the time to talk about whether we should have constructed it differently.  Now is the time to put the fire out.  Then we can talk about how to rebuild the house."

And there are good reasons to believe that the state's challenges of the health care reform bill won't succeed.  Among them:

  • A central provision of the state's lawsuits is that Congress does not have the power to compel Americans to buy insurance or pay a penalty.  But the health reform bill designed the penalty as a tax, which Congress certainly has the authority to do.
  •  The lawsuits also claim that the health care legislation is a violation of state's rights.  But Congress has the power to regulate interstate commerce, and there is plenty of evidence -- inside the bill and outside of it -- that health care is part of the national economy.

So maybe, just maybe, Arizona's lawmakers shouldn't focus on fighting a battle that is probably not winnable - and one whose ultimate outcome would do severe damage to the state's economy (remember, 42,000 jobs lost and $3.3 billion less in gross state product in 2011 alone from Arizona healthcare cuts). 

Maybe, instead, Arizona's lawmakers should focus on putting out the fire that is consuming our state's economy and threatening to make Arizona an unattractive place for businesses to locate and smart, hard-working people to live.


Written on Tuesday, 30 March 2010 13:51 by Gary Yaquinto

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