Medicaid Expansion a Trap, Not a Solution, Says Association of American Physicians and Surgeons

Tucson, Arizona, UNITED STATES

TUCSON, Ariz., March 18, 2013 (GLOBE NEWSWIRE) -- The following statement was issued by the Arizona State Chapter of the Association of American Physicians and Surgeons:

"Arizona's Governor Jan Brewer, like some other Republican governors who say they oppose ObamaCare, is pushing for implementation of a key feature of the Affordable Care Act: an expansion of Medicaid.

"The media campaign features the standard formula of presenting hard-luck stories. An upstanding, hard-working citizen has, through no fault of her own, a serious illness, and has lost her insurance, right in the middle of treatment. The only answer: Enroll her in AHCCCS (pronounced 'access,' the Arizona Health Care Cost Containment System, the Arizona 100-percent managed care Medicaid system).

"We should be asking a couple of questions. First, will she get the treatment she needs from AHCCCS? Answer: not necessarily. She might not be able to find a doctor, or the system might not approve the treatment—or approve it soon enough.

"Second: what will happen if her income rises above the threshold of 133% of the federal poverty level? Answer: she will become ineligible for AHCCCS, possibly right in the middle of treatment.

"While 'job lock' ties people to a job because they fear losing health insurance, Medicaid is a poverty trap that locks people out of getting a job.

"A spokesman for Gov Brewer claimed that, according to the New England Journal of Medicine, a previous expansion of Medicaid saved lives. This study looked at death rates from all causes before and after expansion in three states (New York, Maine, and Arizona). Only in New York did a decline reach statistical significance. Less than 15% of the study population was on Medicaid, and Medicaid may have had nothing to do with the slight decline in mortality rate.

"The federal government promises to cover added costs, at least at first. Gov. Brewer proposes a 'circuit breaker' if funds are not available. If the federal government allows this, what happens to the program's new dependents?

"The governor didn't mention that the state might be able to seize the amount paid into AHCCCS on a person's behalf after age 55 from his estate, even if no actual services were received. For older patients, AHCCCS enrollment is a loan.

"Only one effect is certain: some $2 billion would flow into the coffers of program contractors—managed care plans—and maybe 25% would trickle down to hospitals."

The Association of American Physicians and Surgeons (AAPS), which was founded in 1943, is a national organization representing physicians in all specialties.


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