Arizona hospitals, doctors oppose health-care reform bill that Ducey has endorsed

While Gov. Doug Ducey this week endorsed a U.S. Senate health-care bill that would replace the Affordable Care Act, hospitals and doctor groups have registered opposition to the sweeping overhaul that could significantly cut funding for Arizona.

The bill floated by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., would shift significant control and flexibility from the federal government to states. 

While it largely maintains the tax structure of the 2010 health-care law known as "Obamacare," health-care providers fear and multiple independent analyses predict the Graham-Cassidy bill would result in deep funding cuts. 

Avalere Health, a Washington-based consultant, estimated that the Graham-Cassidy bill would cut $215 billion in federal payments to states through 2026. 

States like Arizona that took Obamacare funding to expand Medicaid for low-income earners would see the most significant reduction in federal funding.

The Avalere report predicts that Arizona would lose $11 billion by 2026. That amount would swell to $133 billion through 2036, the report said. 

States such as Texas and Mississippi, which did not expand Medicaid under Obamacare, would fare much better, the Avalere analysis shows.

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Arizona health-care providers that have reported a significant drop in unpaid bills as more than a half-million residents gained coverage under the Affordable Care Act's marketplace and Medicaid expansion expressed opposition to the Graham-Cassidy bill.

Two Arizona hospital groups — the Arizona Hospital and Healthcare Association and the Health System Alliance of Arizona —  released statements Wednesday opposing the bill.

The hospital association said the Graham-Cassidy bill " ... erodes critical protections for patients and consumers ... "

Greg Vigdor, president and CEO of the hospital association, said the funding cuts are too deep and would likely reduce coverage for many Arizonans.

"We saw this story play out in the Great Recession in terms of uncompensated costs soaring and the damage it does to the safety net," Vigdor said. 

The Health System Alliance, which represents metro Phoenix's four largest hospital systems, said that the Graham-Cassidy bill "not only jeopardizes the sustainability of our Medicaid program, it jeopardizes access to care for all Arizona patients."

The American Medical Association, AARP and a national hospital group also expressed concerns.

Bill gaining momentum

The Graham-Cassidy bill is the latest GOP proposal to replace the Affordable Care Act, former President Barack Obama's signature health-care law passed in 2010. 

A House health-care bill stalled in May, and the Senate's earlier "skinny repeal" bill was defeated in dramatic fashion when Arizona Sen. John McCain and two other Republican senators voted against the legislation.

The Graham-Cassidy bill gained momentum this week when Ducey publicly endorsed it. That prompted political watchers to speculate whether Ducey's support could help influence McCain. 

Daniel Scarpinato, Ducey's press secretary, said the governor believes the bill is a "step in the right direction" even though he doesn't think a single bill will resolve all problems for health care.

The nonpartisan Congressional Budget Office on Monday said it would not have time to comprehensively evaluate the Graham-Cassidy bill's effect on the deficit, health-insurance coverage and premiums before Sept. 30. However, Senate GOP leaders want a Senate vote as early as next week, a time frame that would allow passage with a simple majority. 

The governor's office has not provided any reports or analysis on how the Graham-Cassidy bill may affect Arizona's Medicaid program, called the Arizona Health Care Cost Containment System, or AHCCCS.

Tom Betlach, Arizona's Medicaid director, was not available Wednesday, an agency spokeswoman said.

A key part of the Graham-Cassidy bill would be to issue block grants to states.

States also would have more say over critical health-policy decisions such as whether insurers would be allowed to charge more to consumers based on their health conditions and whether to require plans to include a minimum set of health benefits. 

An analysis by the Kaiser Family Foundation said that the block grants would combine two Affordable Care Act funding sources, marketplace subsidies and Medicaid funding through 2026.

However, the Graham-Cassidy bill's funding would be at lower levels than what the Affordable Care Act guarantees, so states would have to make up the funding gap or reduce coverage. 

Children's Action Alliance CEO Dana Wolfe Naimark said that Ducey's endorsement was a departure from the detailed letter he wrote in January to U.S. House Majority Leader Kevin McCarthy. 

In that letter, Ducey listed concerns about how Medicaid cuts then under consideration by the House could harm Arizona. 

"The bill does not meet any of the criteria the governor (listed) when he did set out thoughtful criteria and benchmarks," in that January letter to McCarthy, Wolfe Naimark said. "What I see from his statement (this week) is the only benchmark is political and we need to check the box that we repealed Obamacare."

Republic reporter Yvonne Wingett Sanchez contributed to this article.

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