AZ Mirror: Trump’s Medicaid cuts will hurt every Arizonan, not just those who lose coverage

Caitlin Sievers, AZ Mirror

The Medicaid cuts that President Donald Trump and Republicans in Congress approved last month will mean higher premiums, longer wait times and reduced services for everyone in Arizona, local health care leaders said Thursday. 

The alarming picture painted by a panel of health care leaders is a direct result of Trump’s “Big, Beautiful Bill Act,” which was backed by all of Arizona’s Republican congressmen. Medicaid provides insurance to 80 million Americans and around two million Arizonans — more than 25% of the state’s residents — with low incomes or disabilities. The new spending law means an estimated 300,000 Arizonans are expected to lose coverage through the Arizona Health Care Cost Containment System, or AHCCCS, the state’s Medicaid program. 

During a panel discussion organized by Phoenix Mayor Kate Gallego and U.S. Sen. Mark Kelly in Phoenix Thursday morning, the health care officials stressed that everyone who relies on the health care system will feel the impact of Medicaid cuts — even if they have private insurance. 

“They still get sick,” Beth Kohler, CEO of the Arizona Association of Health Plans, said of those who will be kicked off of Medicaid. “They still need health care. So, they still go to the hospitals, and the hospitals are required to provide emergency-level care to people who need it.” 

Instead of seeing a primary care doctor, Arizonans who lose insurance through AHCCCS are likely to put off treatment until they’re in crisis and head to an emergency room. 

That means that instead of getting a handle on a health problem early on, more people will wait to see a doctor until it’s an emergency, and hospitals will be on the hook to provide that more expensive care. That could lead hospitals to make tough decisions to close departments and lay off staff. 

“If doctors get laid off and nurses get laid off from hospitals, wait times go up,” Kelly said. “Then maybe you don’t even get that appointment with the specialist, or if a rural hospital shuts down their OBGYN clinic, an expectant mother has to possibly drive hours. That puts children and moms at risk. So, these cuts are devastating.”

When Arizonans are kicked off of AHCCCS, they also lose access to mental health services, said Candy Espino, CEO of the Arizona Council of Human Service Providers. That has the potential to lead to hospitalization, homelessness or incarceration.

“A strong mental health system, it doesn’t just save money, but it saves lives, and we need to consider that as we look at the impacts of this bill,” she said. 

The Grand Canyon State has already seen what happens when a chunk of people lose their health care coverage, Kohler said, because that’s what happened during The Great Recession about 15 years ago. 

“(Health care providers) shifted costs to people who were paying for their health insurance on their own,” Kohler said, adding that the business community supports a robust AHCCCS because employer premiums can increase dramatically when people lose Medicaid coverage. 

The cuts are expected to slash an estimated $1 trillion from federal Medicaid funding across the country over the next 10 years, according to the Congressional Budget Office. Those cuts and others, including to food assistance programs, were implemented to pay for tax cuts for corporations and the wealthy.

The provisions in the bill that are set to make some of the most significant cuts to Medicaid are work requirements, more frequent eligibility determinations and limits on provider taxes. 

Many of the panelists urged Arizonans who are enrolled in AHCCCS or who might need it to continue to update their documentation, when asked, or to apply. None of the changes to the Medicaid program have gone into effect, and there are numerous exemptions to work requirements that could allow them to keep coverage. 

There are exemptions for parents or caregivers of children 13 and younger, for pregnant women, for people who are medically frail and for children and seniors. But panelists said they expect that keeping up with documentation requirements to prove eligibility for exemptions could be a challenge for many. Kohler estimated that the state will have to spend tens of millions of dollars developing infrastructure to determine whether participants meet work requirements or qualify for an exemption. 

And some people who might expect to be exempted from work requirements are not. 

“You have people who are experiencing homelessness,” Kohler said. “You have people who have severe mental illness. You have people who need cancer treatment. You have people who have significant chronic illnesses, who need constant medical care.”

Although the people who lose their coverage will likely be the hardest hit, everyone will feel the effects. 

“I can’t overstate how people need to understand that it’s not that it’s not only that individual who’s being impacted,” said Helena Whitney, a vice president at the Arizona Hospital and Healthcare Association. “It’s every other person who’s also in the emergency department, who has their own private health insurance. If you’re waiting five hours today in the (emergency department) to get seen, you can double and triple that.” 

Ray Ochoa, an assistant chief for the Phoenix Fire Department, said that people can expect Medicaid cuts to impact ambulance services, as well, with first responder agencies eating more costs from patients who can’t pay. 

“(People who lose coverage) may have to use the 911 system to get general health care that could potentially be provided more properly at a primary care physician, an urgent care or specialist, so we can expect to see increased activities and call volumes there and seeing sicker patients,” he said. 

Scott Hall, deputy director of Phoenix’s Office of Homeless Solutions, said that he expects the cuts to exacerbate the homelessness crisis, since Medicaid coverage can help people get back on their feet. 

“The other part that doesn’t get talked about here enough is the people that will be entering homelessness because of this,” he said. “A lot of people divert experiencing homelessness just because they receive the right normal health services and substance abuse services. And as we make that more complex and challenging for people, we’re going to see that exponentially increase.” 

Kelly, the state’s senior Democratic senator, told reporters after the panel discussion that it was vital to get information about the cuts out to the public, including some people who don’t realize that they’re at risk of losing insurance because they don’t know that AHCCCS is Medicaid. 

“Myself and other Democrats in Washington, D.C., are fighting to restore these programs, but to be honest with you, you know, we lost the vote,” Kelly said. “It’s going to take some time. And the purpose of today is to make sure that people understand what they have to do now. We’ve got to make sure that folks have the information so they can stay enrolled.” 

Kelly added that it’s also on the U.S. Department of Health and Human Services to keep Medicaid recipients updated on requirements to keep their coverage, but he emphasized that, under the Trump administration, the federal government has shared inaccurate information with recipients of some other programs, like Social Security. 

“We’re working very hard to be smart about these policies, to make sure our community understands them and to do our best to manage them as well as to find solutions,” Gallego said. 

Read the original article here.