Arizona Senate President Proposes to Cap Medicaid Enrollment if Tobacco Settlement Funds Run Out

Arizona Senate President Randall Gnant (R) has proposed a bill that would allow voters to overturn part of Proposition 204, the ballot referendum that expanded state Medicaid eligibility using money from Arizona's portion of the nationwide tobacco settlement, the Arizona Daily Star reports. If passed by the House and Senate and approved by voters in November, Gnant's proposal would cap enrollment in the Arizona Health Care Cost Containment System, the state's Medicaid program, if the tobacco funds run out (Fischer, Arizona Daily Star, 2/19). Proposition 204, passed by voters in November 2000, expanded health care coverage to individuals whose eligibility is categorically linked to Medicaid (such as parents of Medicaid-enrolled children) up to 100% of the federal poverty level, or about $17,050 per year for a family of four. The measure also expanded coverage for individuals whose eligibility is not linked to Medicaid (such as single male adults and women who are not pregnant) to 100% of poverty. For both groups, the previous eligibility limit was 34% of poverty, or $6,000 per year for a family of four (Kaiser Daily Health Policy Report, 9/17/01). Proponents of the Proposition 204 said that the cost of expanding eligibility would be covered by the $100 million the state receives each year from the national tobacco settlement; the measure contained a provision saying that if those funds were not enough, money would be used from the state's general fund. But Gnant maintains that when voters passed Proposition 204, "they never knew the financial obligations [of expanding eligibility] would cut into the state's operating budget" and were "led to believe that" using state general funds "would be years in the future." Eve Shapiro, head of the Healthy Arizona Coalition, countered that when voters approved Proposition 204, they "clearly wanted to expand the state's indigent health care program, no matter who paid" (Arizona Daily Star, 2/19). According to a staff member from Gnant's office, the proposal to cap enrollment must pass a majority in the state House and Senate before it can be placed on the November 2002 ballot (Jason Baker, Kaiser Daily Health Policy Report, 2/19).