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4/2/2013 2:08:00 PM
County votes to support Brewer on Medicaid
Gov. Jan Brewer
Gov. Jan Brewer

Scott Orr
The Daily Courier

PRESCOTT - The all-Republican Yavapai County Board of Supervisors voted Monday to issue a resolution in favor of Gov. Jan Brewer's support of a major element of President Barack Obama's Affordable Care Act.

The proposal Brewer, also a Republican, is advocating has met with opposition from within her own party. It's a component of the so-called Obamacare plan that expands Medicaid coverage to people earning up to 138 percent of the federal poverty level. That's $15,400 for individuals, and it would add 17 million uninsured adults and children nationally to Medicaid.

Brewer's about-face on the issue puts her in the company of some other Republican governors, such as those in Florida, Michigan, Nevada, New Mexico and Ohio, who will go along with the plan.

It calls for the federal government to pick up 100 percent of the tab in 2014, then 95 percent from 2016 to 2019 and 90 percent in 2020.

While 10 other Republican governors said their states won't participate, Brewer said the federal dollars would go to other states that do accept it if Arizona doesn't.

"The Governor's Office contacted Yavapai County last week," Board Chairman Chip Davis said. "She wanted to reach out to the counties so we could also reach out to our legislators, and I felt it was appropriate to get our resolution out first."

Several key officials and community leaders spoke in favor of the plan, including Tim Barnett, President and CEO of Yavapai Regional Medical Center.

"This is a courageous thing (Brewer) is doing in trying to accomplish this for our state," Barnett said. "We at the hospital treat people that have no other options...but what happens is, (the uninsured) show up in our emergency rooms, and that is the most costly and most ineffective way to treat people."

He said the plan would cover "the working poor in our communities, people trying to make a living, trying to make a go of it."

Yavapai County Attorney Sheila Polk told the board that she had testified two weeks ago at the House Appropriations Committee hearing in Phoenix, explaining why she favors the Medicaid expansion.

She said the plan would "make Arizona and Yavapai County a safer place.

"We saw and have seen an increasing impact on our criminal justice system" as a result of a statewide 2011 freeze on enrollment in the Arizona Health Care Cost Containment System (AHCCCS), the state's Medicaid program, for the single-childless adult population.

"What we have seen is an increase in the number of individuals who suffer from untreated mental illness who end up in our criminal justice system," she said. The problem, she said, is when they end up in jail, "we treat them, we stabilize them, we address the criminal offense, where they still don't qualify for AHCCCS."

Polk said that leads to a "revolving door, where they decompensate, re-offend, and they're back in our criminal justice system."

"That's terrible," said Chairman Chip Davis.

Sheriff Scott Mascher echoed Polk's comments. "I don't think there's any question that our mental health (treatment) procedures are broken," he said, noting that the YCSO gets phone calls from people saying, "'This person needs help,' but they don't fit into any (indigent care) program."

Supervisor Tom Thurman said Arizona might have to join the plan in any case. "It's mandated that a state accepts and does this program unless they prove they can't afford it.

"I have a lot of friends and constituents who believe this is just catering to the Obama administration, but it is what it is. (Congress) passed it, and the president signed it," he said.

"I just want to make this clear: I, in no way, shape or form support Obamacare," Supervisor Craig Brown said, but he allowed that this particular part would be good for the state.

The board voted 5-0 in favor of drafting a resolution in support of Brewer's plan.

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Reader Comments

Posted: Sunday, April 7, 2013
Article comment by: verde voter

Did anyone even read what this is about? Let me ask you? What is the hospital ER or Urgent care gonna do when folks show up with little money or no money to pay for basic needed healthcare? I don't know about YOU PEOPLE. But I do not want sick poor people going to work at low income jobs serving my food, cleaning buildings or walking around the grocery stores. Now wake up. What are you going to do with these people? You can turn you head? but what will that do? You can develop clinics for the poor? possibly like over load Yavapai county clinics. You can ask the religious communities to cover all cost? So Jan Brewer decides to take the federal taxpayer money given to USA states that will take care of their poor people. We have a problem and we need solutions. I suggest ya all get on board to find the answers.

Posted: Sunday, April 7, 2013
Article comment by: Alyce Guinn

Is Brewer going to cover all of the people that are now covered by Obamacare? I doubt it, but perhaps someone can answer. I am suspicious that Brewer is trying to save a few dollars. I am quite sure that she does not respect our President!

Posted: Saturday, April 6, 2013
Article comment by: Maybe you missed something

@ Reject

Obamacare has not been fully implemented yet.

I look forward to getting 80% of my premiums back if I don't use my insurance.

"On June 1, 2012, insurance companies nationwide submitted their annual MLR reports for coverage provided in 2011 to the Department of Health and Human Services (HHS). Based on this data, insurance companies that didn’t meet the 80/20 rule will provide nearly 12.8 million Americans with more than $1.1 billion in rebates this year. Americans receiving the rebate will benefit from an average rebate of $151 per household.

Under the new health care law, rebates must be paid by Aug. 1 each year. As a result, 12.8 million Americans will see one of the following:

•a rebate check in the mail
•a lump-sum reimbursement to the same account that was used to pay the premium if it was paid by credit card or debit card
•a direct reduction in their future premiums
•their employer providing one of the above rebate methods, or applying the rebate in a manner that benefits its employees."

You seem to be able to type, guess you never learned to Google or maybe you are that guy in Prescott that conservatives pay to spread their propaganda?

Posted: Friday, April 5, 2013
Article comment by: @ Michael Calvert

That's the problem: the cost of providing medical care in this country is out of control, and the cost overruns (the difference between the cost of providing medical care and what Medicare, AHCCCS, and some other government agencies actually pay) keeps forcing the cost to everyone else even more out of control. The insurance companies bargain that figure down a bit. That "discount" is also passed along to anyone paying their own bill, all of which results in eye-popping cases like $743 for 15 minutes with doctor who bandaged one severed finger, no stitches (real example).

The health insurance reform act (ACA) does not address this basic problem. Instead, it adds more administration expenses and cost overrun patients.

Since healthcare costs drive insurance premiums, the cost of insurance is equally out of control.

But rather than try to reduce insurance industry overhead, the reform additionally increases costs to insurance companies with a raft of high-cost items that must be insured with no additional premium, no ceiling, and no cancellation.

The rationale given is that younger, healthier citizens who don't need much health insurance weren't buying it , some healthy customers were dropping theirs, and some businesses were deciding against it. By forcing all these non-beneficiaries to purchase insurance, the insurers would be able to absorb higher medical fees, expand coverage, and lower premiums. It hasn't worked this way in Massachusetts, and a glance at your premium renewal will tell you it isn't working this way yet nationwide.

Now, do you still want to "assess" Arizona hospitals $25 million a year and add 300,000 to 600,000 extra AHCCCS patients?

By the way, the health insurance reform act has never been anything except politics. Why should anyone stop now?

Posted: Friday, April 5, 2013
Article comment by: Slater Slater

By the time your done reading the text of O'bama Care your grandchildren will be dead.

Posted: Friday, April 5, 2013
Article comment by: County should reject Obamacare

Problem is the Affordable Care Act is already a failed law. It has failed to make healthcare more affordable, which is what it was intended to do.

You want to apply for this? Talk about impenetrable bureaucracy. The application is some 21 pages, and the instructions are 61 pages, that's 6 times longer than applying for a green card.

Obamacare uses smoke and mirrors for funding. Arizona's support only perpetuates this, obligating us to pay much more than we are now for worse care and less choice.

For us as individuals Obamacare is an absolute monstrosity. Our health insurance premiums are doubling and tripling in cost.

It's perverse incentives reward hospitals like the VVMC who are recruiting physicians as employees to charge twice what they would in private practice, because Obamacare will pay. How wrong is that?

Obamacare does not do what it was represented to do. It does not reduce costs, in increases them. It does not improve care, it makes it worse.

Yavapai County and the state of Arizona should just say no to all of this. And Obamacare should be repealed in its entirety and replaced with something better, something Actually Affordable.

Posted: Friday, April 5, 2013
Article comment by: Michael Calvert

When it comes to the health and welfare of the US public I dont think there is any room for politics! Its about time that the politicians in this country do whats good for the public that elects them. How can the cost of medical care in this country be debateable, its out of control. The wrong people and professionals ( INS COMPANIES) are often dictating the need for care. The idea that money is more important than peoples lifes and well being is ridiculas. What happened to love thy neighbor? Where have our compassion and caring attitudes and beliefs gone? Somewhere below greed, political gain, and selfishness is my guess.

Posted: Friday, April 5, 2013
Article comment by: Gullible Public - Again

Are you really that gullible?
This has nothing to do with Brewer or any other Republican governor doing good for the needy. This is all about making a crafty move that will allow them to say "look how we are sympathetic to your needs and thus deserving of your vote in the next round of elections".
Come on people get a clue.

Posted: Thursday, April 4, 2013
Article comment by: @ Frank Lee Confused

Glad the obamacaristas finally decided what to call Jan Brewer's surprise about-face.

"Pragmatic politics" has a nice ring to it. And congratulations, it's even true. Arizona is in no position to buck an administration that can and will snuff the state's tenuous recovery. We were too dependent on Freddy & Fanny and took no steps to broaden our base back in 2006 when the money was rolling in. Live with it. Go with the flow.

However, I'm calling it "Self-defeating pragmatism" because it's the road to even greater dependency, and at the moment Arizona's healthcare infrastructure is intact and delivery-system solvent.

Now is a great time for healthcare providers to push cost-cutting measures and force fees back into the realm of reality, which they won't do with 300,000+++ more money-draining AHCCCS patients on the roles, a $25-million annual assessment, and the feds eager to donate other people's (in other states) money to care for Arizona's relatively high percentage of borderline poor. Instead, they'll form ever-larger medical co-ops as providers have done in Massachusetts to fight cost cutting and defend their share of the healthcare "windfall."

I have no idea where Brewer and our Supervisors are coming from. But that's why I don't like the feds' idea of health insurance reform, and one of the ways I think Arizona could do it better.

Posted: Thursday, April 4, 2013
Article comment by: Lee Cali

Hurrah for common sense. It seems some Republicans actually have come to realize what's good for their constituents will be good for their re-election also.

Posted: Thursday, April 4, 2013
Article comment by: @ Fact Check

I think the Supreme Court decision was in 2012. The act was passed in 2010. But you're right about the decision. The feds can deny everything from home mortgage loans to additional education grants, but not current Medicaid support levels.

Posted: Wednesday, April 3, 2013
Article comment by: Frank Lee Confused

What we are witnessing here is a bunch of our elected representatives agreeing to take a pragmatic approach to solving a huge problem which affects everyone - especially those of us who aren't fabulously wealthy.

Politicians doing the right thing for the people who elected them. Congratulations, guys!

Now, in order to retain the majority of their support (which comes from the anti Obama voters), they must publicly disavow any personal support for their decision. Politically, they don't want to be perceived as following the president's leadership. But they all know that we must try something to slow the unsustainable rise in health care costs which was well under way and gathering momentum long before the Affordable Care Act was introduced.

To Mr. Brown and Ms. Brewer I would ask, if you don't like the ACA, what would you recommend?

Posted: Wednesday, April 3, 2013
Article comment by: Fact Check

Supervisor Tom Thurman knows this is false...

"Supervisor Tom Thurman said Arizona might have to join the plan in any case. "It's mandated that a state accepts and does this program unless they prove they can't afford it.""

In 2010, the U.S. Supreme Court ruled the federal government can not force states to "join the plan" and can not withhold previously contracted funds if a state chooses not to participate in the Patient Protection and Affordable Care Act's required expansion of Medicaid.

Governor Brewer knows this as well. So do the reporters writing these articles and the editors that choose to publish them..

Posted: Wednesday, April 3, 2013
Article comment by: Lynda Kuglitsch

Thank the Lord for those politicians in Yavapai County who put aside their partisan bickering about Obamacare and did the right thing. Refusing Federal Medicaid funding for needy Arizona childless adults to prove a point is just "cutting off your nose to spite your face". Who would we be hurting by doing this? Obama? The Feds? Not really. It would be our state's poor and the medical facilities that eat the cost.

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