AHCCCS cases proceeding in court

Posted by AzBlueMeanie:

Federal Court

A three-judge 9th U.S. Circuit Court of Appeals panel said last month that AHCCCS violated federal law when it began charging co-payments to certain enrollees last year. Court didn't halt AHCCCS co-payments:

[But] mandatory health insurance co-payments remain in place for some of Arizona's poorest residents despite last month's court decision that ruled such payments violate federal law.

"Basically what this decision did was remand it back to district court," said Monica Coury, an assistant director with the Arizona Health Care Cost Containment System (AHCCCS), which is Arizona's form of Medicaid. "In the meantime, everything remains status quo."

[The co-payments range from $4 to $30 and were imposed by the Arizona Legislature to both stretch health-care dollars and to encourage the childless adult population to use primary-care doctors, Coury said.]

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Those affected were childless adults and those in an AHCCCS program, often referred to as "spend down," that gives temporary assistance to people with medical expenses that deplete their incomes to a level that makes them AHCCCS-eligible. Those populations can be denied prescriptions and medical care if they don't have the co-payment.

The Phoenix-based William E. Morris Institute for Justice estimates more than 220,000 Arizonans had to pay AHCCCS co-payments and that in some cases those people were denied medical care because of their inability to pay.

The institute represents plaintiffs in a class-action lawsuit against U.S. Health and Human Services Secretary Kathleen Sebelius and AHCCCS Director Thomas Betlach.

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Arizona voters in 2000 approved expanding the AHCCCS program to include childless adults who are at or below the federal poverty level – $10,890 per year per person. Childless adults have been unable to enroll in AHCCCS since July 8 because of state budget woes, but those already in the program were grandfathered in. Also, the freeze on childless-adult enrollment is being challenged in federal [district] court.

State Court

The Arizona Court of Appeals will hear oral arguments on October 19 in a lawsuit brought by low-income residents who argue Gov. Jan Brewer's cuts to the state Medicaid program violate the state Constitution and the will of voters. Arizona court agrees to consider Medicaid enrollment cut:

A lower-court judge last month refused to block the cuts, agreeing with attorneys for Brewer and the Arizona Health Care Cost Containment System that a voter-approved law requiring health coverage for all Arizonans below the federal poverty level doesn't force the Legislature to pay for it.

Maricopa County Superior Court Judge Mark Brain's ruling allowed an enrollment cap, approved by federal health officials in July, to remain. That prevents new enrollment or re-enrollment in an AHCCCS program covering adults without dependent children.

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Brewer and state lawmakers cut AHCCCS by $500 million to help balance the current-year budget, capping programs for adults without dependent children and some low-income parents. An estimated 100,000 people will drop off the AHCCCS rolls by June and an untold number will be prevented from enrolling.

A three-judge Appeals Court panel scheduled an Oct. 19 hearing in the case.

I explained at the time that Judge Mark Brain's opinion is flawed legal analysis. Analysis of the opinion on Prop. 204 and AHCCCS. I suspect the judge wanted to kick this up to the Court of Appeals to let them deal with it.