NAVAJO & APACHE COUNTIES — The lawsuit seeking to overturn the Affordable Care Act poses the most immediate threat, with a federal appeals court decision due at virtually any moment.

Getting AHCCCS could get tougher

Congress has whittled away at the program ever since gaining control of Congress and the White House. The repeal of the mandate for coverage and cutting the money for subsidies and marketing has reversed a steady decline in the number of people without medical insurance in the past two years – while driving up the cost of the ACA insurance plans still available.

The ACA remains broadly popular, with support of 77 percent of voters in some recent polls. The overwhelming majority of voters also support key provisions of the ACA, including allowing children to remain on their parent’s health plan until the age of 26 and barring insurance companies from denying coverage to people with pre-existing conditions. This helped blunt efforts to “repeal and replace” the ACA in Congress, but the court case could overturn the act by the back door, threatening coverage for about 10 percent of Arizona’s population.

The foes of the ACA argued before the 5th Circuit Court of Appeals in Texas v Azar that when Congress in 2017 eliminated the penalty for not having insurance, it effectively rendered the whole ACA unconstitutional. The US Supreme Court in 2012 had held that the penalty for not having insurance was key to making the whole act constitutional. A lower court in Texas has already ruled against the ACA. If the appeals court agrees, the case would almost surely go to the US Supreme Court next year – which would be the third time the court has been asked to rule on the constitutionality of the act.

New mandates

Even if the expansion of Medicaid survives that legal challenge, healthcare experts have predicted a continued rise in the number of uninsured as the various federal and state modifications of AHCCCS and other programs take effect.

For starters, the administration has imposed a new rule barring eventual citizenship for any legal immigrant who receives benefits. Current law allows a legal immigrant to qualify for AHCCCS after five years in the country.

Moreover, experts say the work requirement will likely reduce the number of people who can receive benefits – especially in rural areas like Navajo and Apache counties.

The new rules will require anyone on AHCCCS to either report they’re looking actively for work or performing specified community service. Experts say not many people on AHCCCS can work – they’re either single mothers with children who would pay more in childcare than a job would produce or they are medically disabled or too sick to work.

In Arkansas, one in four Medicaid beneficiaries subject to work requirements lost coverage in the first seven months of the program – mostly due to difficulties in filling out the paperwork and providing the required documentation. Despite the loss of coverage by 18,000 people and the work requirement imposed on those who didn’t lose coverage – the program had no impact on the underlying employment rate. Studies suggest that about 60 percent of the people receiving AHCCCS already work and most of those who don’t aren’t able to work.

The new Arizona rules will exempt from the work requirement pregnant women up to the 60th day after they give birth, former foster children up to the age of 26, tribal members, people with a serious mental illness, people with a federally recognized disability, people who are medically frail, survivors of domestic violence, the homeless, the designated caretaker of a child under 18, people on unemployment, people in treatment for substance abuse and full-time students.

AHCCCS estimates only 120,000 people on the program now will end up having to comply with the new requirements, which includes at least 80 hours a month of “community engagement activities.” That would include a job, training, job search activities, community service and education.

Nonetheless, the need for a slew of new documents could cost perhaps 30,000 of those people their healthcare, according to national studies.

Peter Aleshire covers county government and other topics for the Independent. He is the former editor of the Payson Roundup. Reach him at paleshire@payson.com

Peter Aleshire covers county government and other topics for the Independent. He is the former editor of the Payson Roundup. Reach him at paleshire@payson.com

(5) comments

Tired

When did this paper become a bleeding heart liberal line of bologna? What a waste of time to read this one.

ArizAl

The more government services that conservative republican politicians take away from poor people,the more it will allow for more taxes to be cut for the benefit of the wealthy and corporations. It also allows for the shifting of government revenues from helping millions of the working poor and needy families on Medicaid/AHCCCS to using those revenues for corporate welfare for profitable mega corporations and by defacto, their wealthy CEOs. A republican disaster in the making! If the ACA is declared unconstitutional, then poor and uninsured americans will be forced to go to the much more costly emergency rooms for even minor medical problems, where by law, they cannot be turned away. We the taxpayers will be paying for their routine medical visits either to the emergency room ,(without Medicaid/AHCCCS) or to a primary doctor (with Medicaid/AHCCCS)....pick your poison, it all affects the deficit and the national debt. How long have we been waiting for congressional republicans to formulate a better than Obamacare healthcare plan as they promised? 11 years ago?

It is rather interesting that republicans hate Obamacare even though Obamacare is patterned after the republican healthcare plan in Massachusetts put together by then republican Gov. Mitt Romney and his administration with the help of Jonathan Gruber, the same man that helped put together Obamacare.

Published by the republican think tank, The Heritage Foundation on October 2, 1989,excerpt of a study of the proposed Heritage healthcare plan, "Assuring Affordable HealthCare for All Americans," which included the Individual Mandate:

""Society does feel a moral obligation to insure that all it's citizens do not suffer from the unavailability of healthcare. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself. A mandate on households certainly would force those with adaquate means to obtain insurance protection. Under the Heritage plan, there would be such a requirement."

Russ_in_WML

Obamacare is horrible, lacking and hugely expensive. Get rid of it.

Russ_in_WML

"...the administration has imposed a new rule barring eventual citizenship for any legal immigrant who receives benefits. Current law allows a legal immigrant to qualify for AHCCCS after five years in the country."

awesome, great job Mr President. Round them up and send them back too.

ArizAl

The more government services that conservative republican politicians take away from poor people,the more it will allow for more taxes to be cut for the benefit of the wealthy and corporations. It also allows for the shifting of government revenues from helping millions of the working poor and needy families on Medicaid/AHCCCS to using those revenues for corporate welfare for profitable mega corporations and by defacto, their wealthy CEOs. A republican disaster in the making! If the ACA is declared unconstitutional, then poor and uninsured americans will be forced to go to the much more costly emergency rooms for even minor medical problems, where by law, they cannot be turned away. We the taxpayers will be paying for their routine medical visits either to the emergency room ,(without Medicaid/AHCCCS) or to a primary doctor (with Medicaid/AHCCCS)....pick your poison, it all affects the deficit and the national debt. How long have we been waiting for congressional republicans to formulate a better than Obamacare healthcare plan as they promised? 11 years ago?

It is rather interesting that republicans hate Obamacare even though Obamacare is patterned after the republican healthcare plan in Massachusetts put together by then republican Gov. Mitt Romney and his administration with the help of Professor Jonathan Gruber, the same man that helped put together Obamacare.

Published by the republican think tank, The Heritage Foundation on October 2, 1989,excerpt of a study of the proposed Heritage healthcare plan, "Assuring Affordable HealthCare for All Americans," which included the Individual Mandate:

""Society does feel a moral obligation to insure that all it's citizens do not suffer from the unavailability of healthcare. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself. A mandate on households certainly would force those with adaquate means to obtain insurance protection. Under the Heritage plan, there would be such a requirement."

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