Medicaid expansion is almost certainly coming to Arizona. Gov. Brewer is behind it and even some conservative legislators are starting to waver. The deal the feds are offering is just too tempting to pass up.
But life experiences teach us that if something seems too good to be true, it usually is. If there was anything clearly “too good to be true”, it would be this deal from the feds, promising nearly a 10:1 match if Arizona will expand its AHCCCS (Medicaid) population to everyone under 133% of the Federal Poverty Level. That may seem like a lot of folks in a program originally intended to help only the poorest of the poor but – hey, the feds are picking up the tab so why worry?
But legislators would be well advised to look before they leap. One nagging problem is that the generous federal government is out of money. For Arizona to take on massive new spending obligations on the premise that the Feds will continue to underwrite them is foolish, to put it mildly. The Feds are only promising the help until 2020 but we’ll be lucky if it lasts that long.
For the short term, the pressure from health providers and insurance companies to get their hands on the bucks is understandably intense. But this is a prime example of how the welfare state grows. Probably no welfare program is more notorious for trapping people in poverty than is Medicaid. For a young single mother with with multiple children, the quintessential Medicaid beneficiary, the prospective loss of her health care benefits is a rock-solid barrier against economic advancement. She literally can’t afford to get a job or be promoted.
No question, short term, the Infusion of billions of federal dollars into Arizona is an attractive proposition. 10 years down the road, the decision to take the deal will look a lot different.
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