As the economy continues to struggle and tax revenues continue to trickle, Arizona continues to have difficulty balancing the budget. Health care costs for its Arizona Health Care Cost Containment System (AHCCCS, pronounced like access) are more and more difficult for the state to pay for, especially as more people become eligible for care (AHCCCS is the state’s version of Medicaid). Without enough money to pay for its existing coverage, AHCCCS is now cutting some of its services to patients over the age of 21. Some of these cuts to services could be life-threatening. While these cuts only affect some Arizonans for now, under ObamaCare, could Federal financial difficulties result in these kind of cuts nationwide?
Under AHCCCS budget cuts, many transplants will no longer be covered. Lung transplants will no longer be covered. Patients with hepatitis C will no longer be able to have a liver transplant. If you are a patient with non-ischemic cardiomyopathy, AHCCCS will no longer cover a heart transplant. Unless you are also getting a kidney transplant, pancreas transplants are no longer covered. Allogeneic unrelated hematopoietic cell transplants will also not be covered. Although this will probably affect a small percentage of the population that relies on AHCCCS, these procedures can cost quite a bit, and it may be cost prohibitive for most people to pay for these transplants on their own.
AHCCCS will not cover well visits for adults after October 1, 2010. While adults are over the age where they need to get growth checkups, they do sometimes have well visits in order to have preventative tests made. My husband’s doctor, for example, often wants him to make well visits due to his sickle cell anemia. Fortunately, these kinds of doctor visits are less expensive than transplants. For low-income adults, it can be cost-prohibitive to pay for these kinds of visits.
Legs and Feet
Low-income adults receiving AHCCCS medical care will no longer have some coverage for problems that could occur in their legs and feet. AHCCCS will no longer cover orthotics or visits to a podiatrist. Patients with prosthetic joints and limbs will also see coverage cut, as microprocessor-controlled lower limbs and lower limb joints will no longer be covered.
Other Services Not Covered
Several other services will no longer be covered for Arizona’s adult Medicaid patients through their AHCCCS program. Hard of hearing patients will no longer be able to receive bone-anchored hearing aids or cochlear implants. Insulin pumps and percussive vests will no longer be covered. Physical therapy patients will be limited to 15 outpatient visits per year. Most dental care will not be covered (although this service was already severely limited). Non-emergency medical transportation may also be limited.
The Future of American Care?
Obama’s health care plan would probably bring back these services for low-income adults, initially. If America’s economy continues to struggle, even a national health care system would eventually have to make cuts. Arizona’s legislators probably did not want to make cuts to their health care system; only a few years ago, then-governor Janet Napolitano wanted to increase eligibility for state medical access. When governments cannot balance the budget, cuts have to be made. While these cuts currently only affect Arizona’s low-income adults on AHCCCS Medicaid, they may affect more people in the future, if ObamaCare extends to a large segment of America’s population.
Acute Care Member Benefit Change. Letter from Health Choice Arizona AHCCCS Administration, August 2010.