Arizona Gov. Jan Brewer is asking HHS for a five-year waiver(PDF)
to reduce Medicaid rolls and increase member cost-sharing but also restore some organ transplant benefits.
In a request to HHS Secretary Kathleen Sebelius (PDF)
dated March 31, Brewer sought approval for a plan to freeze Medicaid enrollment for childless adults and parents. Her plan also includes eliminating emergency coverage to those who can't prove citizenship, and installing new co-payments for enrollees. She also is seeking to add a $50 annual coverage surcharge for smokers and adults with chronic conditions who don't stick to a care plan and meet goals to improve their health.
An estimated 160,000 childless adults and parents are expected to fall off Medicaid rolls this year as a result of the proposed freeze. Enrollment changes for low-income parents would necessitate a waiver from “maintenance of effort” provisions in the federal health reform law, which requires states to maintain enrollment levels to draw down federal funds.
Brewer's plan also includes restoration of transplant benefits that were cut this fiscal year. The governor said in the letter that these cuts would no longer be needed if other changes to Medicaid are approved.
Brewer previously announced a $500 million proposal to drastically change Arizona's Medicaid program, which includes further reimbursement cuts to providers. The plan requires approval from the federal government and the state Legislature.