AHCCCS NOT A Model for The Nation
AHCCCS is Arizona’s Medicaid program that provides free healthcare for Arizona’s poor. The state’s program has doubled in size over the past 10 years and just in the past four months, enrollment has increased by another 100,000. AHCCCS is one of Arizona’s largest programs and eats up 16 percent of the state’s entire budget at a cost of $1.5 billion to the General Fund.
The state deficit and the growing need is straining the program to the point where it may be necessary to re-evaluate which medical services may need to be eliminated to control costs. The program may need to cut reimbursement rates to providers even further.
AHCCCS already underpays physicians and hospitals at rates 20 to 30 percent below the actual cost of care, shifting costs onto private insurance. In true trickle down fashion, those costs are passed onto businesses and employees who must pay higher costs to receive the same type of health coverage.
AHCCCS is currently an unsustainable model and from various bills floating around in the U.S. Senate, the program’s costs will likely increase again by $1.2 billion to $5.9 billion depending upon how many people are eligible for the program.
Clearly Arizona’s Medicaid system cannot sustain itself. It is expanding rapidly, and has a detrimental affect on the private sector. Based on these factors it is unclear how AHCCCS can be a national model for the healthcare reform debate.
Some better ideas for healthcare reform may include incentives for wellness and prevention care and perhaps allow individuals to purchase health care plans across state lines, which would drive down costs and provide a wider menu of options.
Affordable Coverage W/O More Government
We all want the same thing – protection from catastrophic illness and the security of affordable health coverage in the future. To their credit, Americans have read the bills working their way through Congress and are objecting to the health care rationing and control over their health care quality and decisions. Can we achieve health care solutions without Obamacare? Absolutely!
The 5 percent of Americans under 65 owning Health Savings Accounts (just since 2003) signals a marked shift toward patients rather than insurance companies directing their health care – and with positive results. Forty-one percent of these were previously uninsured and nearly half have incomes of $50,000 or less. Studies show they are offered more wellness incentives and are more likely to use preventive care. Congress’ plans for insurance standardization and mandates will stop this progress.
Plus, Arizonans will have lower cost insurance options since our reform-minded Legislature changed the law this session. Why should everyone be forced to buy the same “Cadillac” coverage – including such benefits as maternity for adopted children or drug treatment – when one without meets their needs? “Government-approved” mandate-laden insurance, as proposed by Congress and that Massachusetts passed, greatly increases premiums, causes over-utilization of services, under-compliance and fewer choices – especially for the young and healthy who would rather pay penalties than high priced premiums.
Arizona also passed significant medical liability reform this session which will bring doctors to the state and discourage defensive medicine practices to avoid frivolous malpractice lawsuits. Ninety-three percent of U.S. physicians admit to practicing defensive medicine at a cost of $210 billion in 2008 and another $865 billion in indirect costs annually. These are reforms the President and Congress have rejected completely.
Nearly one in five Arizonans lacks health coverage largely due to government’s failure, not market failure, to correct the perverse incentives and over-regulation that drive up costs in both.
Before selling yet another government panacea to the American people – Congress should stop the billions of dollars of waste in the Medicaid and Medicare systems – moving them towards solvency. To increase competition it should enable cross-state purchasing and stop the tax discrimination preventing affordable and portable insurance for individuals.
If, in the end, heavy-handed policies are forced upon the states, Arizona will have Constitutional protection – the Arizona Health Care Freedom Act – as a defense if passed next year at the ballot. At last count 13 other states are taking similar stands against government intrusion into their health care decisions and mandates.
Critics of the vocal opposition to Congress’ plans, such as E.J. Montini (“Uninsured Lost Amid the Shouting”), consistently claim opponents support the status quo and are fine leaving the uninsured problem unresolved. But thorough reporting of the patient-centered reform proposals in Congress – such as individual tax credits – and policies transforming health care in Arizona and other states – like risk pools – would add balance to the discussion.
We are witnessing engaged Americans who stand ready for an honest debate on health care reform. Choosing which direction it takes is not above their pay grade and may even give real hope to those whose only hope, we’re told, lies in more government control and loss of their own.
Nancy Barto is the Chair of the House Health and Human Services Committee and represents District 7. She can be reached at 602-926-5766 or via email at nbarto@azleg.gov
Speaker Adams Forms Official Private School Tuition Tax Credit Review Committee
Yesterday Speaker Kirk Adams announced the formation of the Private School Tuition Tax Credit Review Committee, tasked with reviewing and assessing the individual tax credit program for private schools.
“Tuition tax credits are very important to Arizonans, and they merit a formal House committee review process,” Speaker Adams said. “This committee will review the impact of these tax credits and make recommendations for their future use,” he added.
The committee has been formed to ensure the application, administration and approval process for tax credits includes accountability measures for private student tuition organizations.
Speaker Adams assigned Rep. Rick Murphy as the Chair of the Committee. He also appointed Representatives Andy Biggs, Debbie Lesko, Jack Brown and Tom Chabin. The first meeting of the Private School Tuition Tax Credit Review Committee will be announced shortly.
“The tuition tax credit program has provided educational opportunities to many students and options to many parents,” Rep. Rick Murphy (R-Peoria) said. “It is important the process for providing tax credits work the way it was intended.”
The committee will produce a report on the tax credit issue by December 15, 2009, which would include any necessary legislation for the 2010 legislative session.
Legislators To Discuss H1N1 Flu
Tomorrow a joint meeting between the House and Senate health committees will hear from state and county officials about the novel H1N1 flu virus, commonly referred to as “swine flu,” and vaccine safety, vaccine supplies and mass vaccination planning.
According to Rep. Nancy Barto, House Health and Humans Services Committee chair, this meeting is timely, important and designed to answer Legislators’ questions about vaccinations.
“Legislators want the opportunity to talk with state and county public officials about the swine flu to address specific questions and concerns they are hearing from their constituents,” Rep. Barto said.
Addressing the joint health meeting will be Interim Director of the Arizona Department of Health Services Will Humble and Dr. Bob England from the Maricopa County Department of Public Health. In addition to discussing vaccine safety, each will also talk about the state and county H1N1 response plans, school readiness and public outreach efforts.
“Arizona needs to be ready to handle this upcoming flu season and this joint meeting will help us see how ready we really are,” Rep. Barto explained. “Federal officials are saying that up to 40 percent of the U.S. population could develop H1N1 symptoms this flu season and thousands could die. Reports are breaking about the fact there is a problem with vaccine production,” she said. “We need to know what this means for the state of Arizona and how we plan to respond.”
This joint meeting will answer that and many other questions about the H1N1 flu season. The meeting is scheduled for Thursday, September 17, 2009 at 2:00 p.m. in Senate Hearing Room 1. All members on both committees are expected to attend.
To review the agenda for the meeting, click here.
Rep. Tobin - "Restore Funding to State Parks"
This past weekend news broke about the state parks’ plan to layoff 30 employees and reduce park hours of operation. Few know about the behind the scenes work being done by Majority Whip Andy Tobin (R-Paulden) to restore funding to the state park system through utilization of the Growing Smarter fund.
“The economic downturn has virtually eliminated growth demands near urban areas,” Tobin explained. “Transferring $20 million from the Conservation Fund in FY10 and 11, while also expanding the lifetime of the fund from 2011 to 2013 ensures Conservation funding will be restored,” he added. “We want to use the money from the fund to ensure the economic contribution of the state parks to Arizona continues.”
According to the Paulden Republican, Rep. Warde Nichols sponsored HB2088 this past Regular Session and had it passed with the required three-fourths vote the measure would have transferred $20 million from the FY09 Conservation Fund to offset land use budget reductions, reversions and suspensions. HB2088 sought to change Proposition 105, the Growing Smarter Act, which provides grants to conserve open spaces in high growth areas.
“I believe this is an excellent use for the Land Conservation Fund since the downturn in the economy has significantly slowed city growth patterns across the state, while the fund has continued to expand by $20 million a year,” Tobin said. “This bill extends the Land Conservation Fund by an additional year and the money we take this year will be restored in 2013.”
Last week Rep. Tobin sent a letter to Arizona mayors, city council members, county supervisors, state department heads, the Governor and stakeholders urging them to contact Legislators who opposed HB2088 last February. The state parks funding restoration issue will be revisited and Rep. Tobin hopes pressure from stakeholders will garner the necessary three-quarter votes to utilize the Growing Smarter funds for state parks.
Arizona State Parks are an extremely valuable attraction for visitors and citizens. Approximately 2.2 million people visit our parks each year and direct spending by those visitors surpasses $160 million each year. Annually, state parks generate $266 million in revenue for Arizona. Rep. Tobin wants to see Prop 105 changed temporarily to allow Growing Smarter dollars to go to state parks this year.
We Shouldn't Rush To Sell State Land
By Representative Lucy Mason (R-Legislative District 1)
I read with interest various news articles advancing the idea that Arizona dispose of its State Trust lands in order to fill the current budget gap. State Trust land is among the most valuable assets Arizona has, and there are a few things to know before we engage in a statewide “fire sale” of it.
Set aside for a moment the issue of whether it would be wise to try to sell any land in this economy, it is important to acknowledge that such a liquidation of Trust land would be legally impossible absent both a voter-approved change in the Arizona Constitution and AN ACT OF CONGRESS! Realistically, this proposal offers NO relief for the current budget crisis.
Arizona’s State Trust lands, which were acquired from the federal government, were placed in a “perpetual trust” so they could be sold when the market demand pushed prices to their peak. The prohibition against wholesaling state land required each parcel to be sold to the “highest and best bidder at a public auction,” was first imposed by Congress in Arizona’s Enabling Act.
Under both federal and state law, Arizona Trust lands must be sold at “true value” based on appraisal in order to make money for Trust beneficiaries. The most significant beneficiaries are the state’s K-12 public schools, who own 87 percent of the Trust lands. Other beneficiaries include the School for the Deaf and Blind, the State Hospital, the Miner’s Hospital, the Pioneer’s Home, and, of course, the three Universities. It would not only be a violation of the Federal Enabling Act, the Arizona Constitution, and Arizona statutes to conduct a proposed fire sale but fool hearty to risk shortchanging these beneficiaries.
Further, it is a well-settled fact that unplanned, unimproved land fetches the lowest price. Almost all of Arizona’s State Trust land falls squarely into that category. However, each year a few thousand acres can be planned, then leased or sold at prices that reflect enhanced values.
A real world example is the Desert Ridge property in Phoenix, north of Highway 101 around Tatum Boulevard. About 30 years ago, it was suggested that, that land be sold for about a thousand dollars an acre. Supporters cited the land’s lack of desirability due to location. It was, after all, pasture land “out in the middle of nowhere.” Meanwhile, the City of Phoenix grew and eventually annexed that land. A freeway was built, utilities arrived, and uses were designated. This proved to be truly lucrative for the beneficiaries. In recent years, some of that land sold for up to $1 million per acre. Nowhere is the axiom, “timing is everything” more true than with the sale of land.
Again, Arizona’s Trust land was intentionally placed into a perpetual Trust. This means that public schools and all the other beneficiaries are entitled to wait until the time is right to sell each parcel. That was what Congress intended, and that is what the framers of Arizona’s Constitution intended. Let’s honor their intent, and not rush to sell out State Trust Land through a hasty lack of vision or panic driven precedence setting policy.
Lucy Mason is the Chair of the House Water and Energy Committee and represents District 1. She can be reached at 602-926-5874 or via email at lmason@azleg.gov.
Neither Governor Nor Democrats Helping With Arizona's Fiscal Crisis
The Governor’s recent reversal of necessary spending cuts defies logic and I simply don’t understand it. I’ve known Governor Brewer for a long time and I’ve always liked her. That is why it is so difficult for me to understand this recent action that simply makes no economic sense. Meanwhile, Democratic legislators are putting politics over helping the state.
Our state is over $3 billion short and is spending more than it has coming in every single day. Simply put, we are paying for things we can’t afford. So the fiscally responsible Republican legislators made the difficult, but necessary, decision to make modest spending cuts and passed a balanced budget, without a tax increase, three times. Unfortunately, the Governor has vetoed it or threatened to veto it all three times. If she didn’t, the budget could have been balanced on June 4th.
The Governor’s most recent vetoes have increased spending by $714 million and increased property taxes by $250 million a year. Unless changed, a vast majority of this $714 million increase in spending and the entire $250 million increase in property taxes will continue into future years. This action adds to the already huge gap between spending and revenues instead of decreasing it, meanwhile increasing the tax burden on the public at a time when individuals and businesses are struggling to stay afloat. This is obviously the wrong direction we should be moving in.
What’s next? I don’t know. The Democratic legislators don’t want to help. They would rather see the Republicans crash and burn instead of helping the state balance its budget.
Why would they take on the responsibility of having to make cuts when they can just let the Republicans take all the blame? Not one of them voted for the three balanced budget packages. The Republicans can try once again to re-negotiate with the Governor, but she has the final and ultimate vote.
Rep. Debbie Lesko represents Legislative District 9, which includes Sun City, Youngtown, and parts of Glendale and Peoria. For more information, visit: www.DebbieLesko.org. Debbie can be reached at 602-926-5413 or DLesko@azleg.gov.
AZ Needs Comprehensive Budget Strategy
Arizona’s unemployment rate is the highest it has been since 1983, with the private sector sustaining the second-highest job loss in the nation, second to only Michigan. Arizona families and businesses continue to struggle to make ends meet, while government leaders toil to find a solution to get the state moving in the right direction again.
Arizona Republican lawmakers understand we cannot cut the state budget or raise taxes enough to revive the economy. The only solution is to develop a pro-business, job creating, economic growth package that allows the state to emerge successfully from this economic downturn.
Legislators from both sides of the aisle agree on one thing: Arizona’s economy needs to turn around and start working for the citizens in this state once again. However, we are somewhat less agreeable on how to deliver that recovery.
The state’s Democrats want to expand the tax base, increase government spending and consistently vote against a responsible balanced budget package. Whereas, Republican lawmakers think the answer to fixing our economy is found in a comprehensive tax reform plan designed to stimulate job creation and attract businesses to the state.
Our plan begins with the passage of a responsible, balanced budget that works to bring government state spending in-line with actual revenues. Arizona’s spending exponentially expanded during the Napolitano years and is now unsustainable.
The budget plan sent to the Governor has been criticized for inclusion of a tax reduction package even though it benefits individuals and businesses. Opponents of our tax plan would like voters to believe it’s a $650 million give-away in tax cuts to corporations and special interests. Not true.
In order to have a robust economy, solid pro-growth policies must be implemented. No other state in the nation is focused on growing out of the recession. Taking more from taxpayers in a recession is a recipe for disaster and does not create an environment for recovery or job growth.
If passed, Arizona’s tax package would be a major pro-growth package to support Arizona jobs, businesses, and economic activity. Specifically, our plan will:
Repeal the State Equalization Property Tax providing $250M in property tax relief to residential and business property taxpayers in FY10 and beyond;
Reduce the assessment ratio for secondary property tax on commercial property from 20% to 16% beginning Tax Year 2012;
Permanently reduce the Corporate rate from 6.968% to 4.86% ($200 million total), moving Arizona from the 23rd most competitive state to 7th best in the nation, bypassing states such as Utah, Florida, and Virginia, starting Tax Year 2011; and
Permanently cut Arizona’s Individual Income Tax rates across the board by 7% ($200 million total); every taxpayer will receive a 7% income tax reduction starting Tax Year 2011.
Our tax package incorporates pro-job tax reductions designed to encourage Arizona businesses to expand operations, create jobs and restart economic growth; as well as, create a pro-business environment to entice people and businesses from neighboring states and across the nation to come to Arizona to set up businesses.
Rep. Steve Montenegro from District 12 represents the cities of Litchfield Park, Goodyear, Surprise, Glendale, Buckeye, El Mirage, Avondale, West Phoenix and Waddel. Contact Rep. Montenegro at 602-926-5955 or via email at smontenegro@azleg.gov.