Tuesday, June 20, 2017

Goldwater Institute wants 400,000 Arizonans to lose health care

Howard Fischer reports in the Daily Star that the Ducey administration argues to keep hospital levy paying for AHCCCS care.

This is a big deal for health care nationally (the secret GOP plan in the Senate) and for Arizona’s citizens benefiting from the expanded Medicaid.

PHOENIX — The Ducey administration is asking the Arizona Supreme Court to preserve the levy that pays for an expanded Medicaid program — assuming that expansion isn’t undermined by Congress killing the program.

In legal papers filed Friday, attorney Doug Northup wants the justices to reject arguments by Republican lawmakers that money being paid by hospitals to the Arizona Health Care Cost Containment System is a tax. Instead, he contends, it is simply an “assessment” on hospitals.

That difference is more than wordplay.

The Arizona Constitution says taxes can be enacted only with a two-thirds vote of both the House and Senate. The 2013 legislation to both restore Medicaid coverage to some who had been cut, as well as to expand who is eligible, did not get that margin.

So unless the high court agrees with the governor and his AHCCCS director, the $265 million a year now being collected goes away — as does health care coverage for about 400,000 Arizonans.

Northup is not the only one asking the Supreme Court to spurn the Goldwater Institute’s bid to classify the levy as a tax. The Arizona Center for Law in the Public Interest, which represents some people who would lose coverage if the levy goes away, also weighed in Friday with its own defense of the law.

The filings are in response to a last-gasp bid by GOP opponents of the levy to quash it. Both a trial judge and the state Court of Appeals previously rejected their argument that it is a tax.

The Goldwater Institute wants to call the $265 million a tax and thus have it run afoul of Arizona’s 2/3 tax rule.

… attorney Christina Sandefur of the Goldwater Institute, representing the challengers, is telling the justices those earlier decisions were a mistake.

She also says this is about more than Medicaid. Sandefur is arguing that allowing lawmakers to label any and all new levies an “assessment” essentially guts the voter-approved requirement for a two-thirds vote for raising new revenues.

Whatever the justices decide could end up being moot.

The American Health Care Act, approved by the U.S. House to replace the Affordable Care Act, would end much of the extra funding the federal government now provides for Medicaid expansion starting in 2019.

Along with the other GOPlins in the House, our own CD2 Rep. Martha McSally voted for the AHCA even though it would negatively affect many of her constituents.

Right now the action is in the US Senate where Mitch McConnell is secretly crafting some version of the House’s AHCA. But even the Senators themselves have little to no idea about what’s in that version or what problems it aims to solve as vox.com reported in We asked 8 Senate Republicans to explain what their health bill is trying to do. For example:

Tara Golshan (vox.com): “… generally speaking, what are the big problems it is trying to solve?”

John McCain: “Almost all of them. They’re trying to get to 51 votes. … You name it. Everything from the repeal caucus, which as you know, they have made their views very clear — Rand Paul, etc. And then there are the others on the other side of the spectrum that just want to make minor changes to the present system. There’s not consensus.”

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