CMS must rule on controversial Arizona waiver by Sept. 30

The deadline for the CMS to approve or deny a controversial Medicaid expansion waiver request by Arizona is Friday. The state’s Republican governor, Doug Ducey, wants to transition Arizona from a traditional Medicaid expansion put in place by his predecessor to a more conservative one.

Ducey wants to make premium contributions mandatory, regardless of beneficiary income level. Those whose income is above the poverty line and don’t pay, coverage would be canceled. The waiver would also require unemployed beneficiaries to show they’re looking for work and terminate benefits for “able-bodied adults” after five years.

The requests were made when applying to renew a 1115 waiver in place since 1989 that allows the state to place most beneficiaries in managed care. If the CMS doesn’t allow the changes, state law requires Arizona to re-apply for them each year. Since expanding Medicaid, 315,000 people have gained coverage.

Hospitals in the state are against several of the changes. “A five-year limit on benefits is arbitrary and would needlessly limit a person’s access to medical services,” Greg Vigdor, CEO of the Arizona Hospital and Healthcare Association, wrote in a letter to the state’s health department last year.

The association also raised flags about the premium lockouts. If patients lose coverage, they are likely to seek care in less appropriate, more expensive settings such as emergency departments.