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Arizona eliminates health insurance for 357,000

The NYT reported last Thursday that Arizona--facing a large budget deficit--is the first state to completely eliminate its Children's Health Insurance Program, eliminating coverage for 47,000 low income children. The state will also roll back Medicaid coverage for childless adults, which will eliminate health insurance for 310,000.

State leaders said they were left with few choices because of a $2.6 billion projected shortfall next year. But hospital officials and advocates for low-income people said they were worried that emergency rooms would be overrun by patients who had few other options for care, and that children might suffer enduring developmental problems because of inadequate medical attention.

The cuts also mean the state will forgo hundreds of millions of dollars in federal matching aid, and could lose far more if Congress passes a health bill that requires states to maintain eligibility levels for the two programs.

Ms. Brewer, a Republican, has warned that more cuts will be needed if voters do not approve a referendum in May to raise the sales tax by a penny for three years, to 6.6 cents per dollar.

I don't think Arizona will be the last state to do this. The fiscal situation facing the states--including my home state of California--is dire.

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FLASH -- CNN reports that the Democrats in the House will vote straight up and down on the Health Care Bill. Deem and pass is out the window.

The for eligibility for CHIP was raised when Michigan fell on hard times, and I presume it keeps getting raised as more people lose their insurance to unemployment and the COBRA runs out. One of the provisions of current health bill that I understand will kick in pretty quickly if the bill passes is that companies can't turn down kids with pre-existing conditions.That's good news, sorta. However, in the current landscape, insurance for your child alone is just about impossible to procure; you have to add your child as a rider on an adult policy. (The YMCA in Grand Rapids offers a city-wide policy based on need, but that's a local exception.) There's nothing in the bill to require companies to offer child-only policies. Moreover, whether insurance companies will offer insurance for kids at any kind of reasonable rate is a wild card. In my worst-case scenarios, I envision a kind of donut hole for the middle class in which those of us at the bottom end of the income range will be ineligible for Medicare/CHIP and priced out of insurance from private sources, even with government subsidies.

As I understand it, pre-exist exclusions for adults will not be eliminated for about 4 years --- correct?Ditto on caps on premium increases.That leaves a lot of time for folks to continue to be ripped off and for people who can't get coverage for their pre-exist to suffer and quite possibly die.In many respects, passing something tomorrow will be a hollow victory.

Let them inject cake.

Jimmy, that's correct. This is a poor bill. I believe rejecting it will simply feeds the notion that nothing needs to be done. Even as I type this, the "no's" are up two, 214 to 212.

Man, you guys are a tough crowd. I'm certainly willing to describe the bill as less than perfect, but it's hard for me to describe a bill that extends health insurance coverage to 30 million people--the largest expansion of social provision in the United States since the Johnson Administration--as a "poor bill." Everyone's entitled to their opinion, of course...:-)

CNN says that the bill still allows denial of coverage if you have a pre-existing condition for 5 more years. Not good.

If Medicaid is not picking up the medical expenses for poor people, who is? Will hospitals just have to absorb the costs of treatment? How will that play out exactly? It's a terrible sign of how bad things are.

JeanYou don't understand - you can't be "priced out" of coverage. It's mandatory. If you don't get "qualifying" coverage as defined by Uncle Sam, you get fined. You see, all the government has to do is say it's so and it's so. Everyone who thinks this is a hunky dorry idea really should look at the Massachusetts model. The governor announced a $300 million shortfall in health case, a must pay item, so they are cutting everything else. This after raising the sales tax by 25% a year and a half ago and getting enormous subsidies from the feds to prop up this "model" system.Oh, they can raise taxes again, and drive more and more business out of the state, and have a smaller and smaller tax base and increased unemployment.As I keep trying to say, the only way to address health care is to lower costs, and this bill does not do that.

What no one is talking about enough is the fat must be cut from other Muninicipa, State and Federal perks. Policeman and fireman are retiring with a pension of $150,000 a year. Other civil servants are getting pensions that are not comparable anywhere in business. Except in Wall St.If Arizonal cut health care for its civil service employees there would be a riot. As usual no one to advocate for the children.

Sean H., if I'm reading your tone correctly, I think we agree to some extent. Requiring people to purchase health care is hardly the same thing as making it affordable. Where we would disagree, I suspect, is how to rectify that. IMO, a single payer system with greater focus on wellness and controlled access to unnecessary procedures strikes me as a better deal. Howevever, that's even more "socialistic" than the current bill, and it just won't fly, not no way, not no how.Peter N., if you were a 55-year-old woman who cannot now afford health care, you would essentially be looking at another four years without it to see whether or how much the government will kick in toward your premiums is such a great deal.

Sorry, got lost in my own sentence: Peter N., if you were a 55-year-old woman who cannot now afford health care, you would essentially be looking at another four years without it, and waiting to to see whether or how much the government will kick in toward your premiums. Would that seem like such a great deal?

Bill, I don't know where you get that nonsense. I'm a senior public service administrator. I make less after 20 years service than new grads in my profession make starting out in the private sector. I'm a taxpayer, too, and at the same rate as everyone else in my income bracket. And after about 20 years in government, (much of it advocating for children, and for health care, btw) I'm looking at a possible pension of about $1600/mo - IF my state doesn't go broke before I'm ready to draw down. While there are a few who may do well at the public trough when it's time to retire, the vast majority of us just hope to get by.And I remind you, that the problem there would not be that public employees may have pension funds, but that the Reaganites managed to make it ok for private employers to drop them, in favor of the fully employee funded 401k if anything. So when it comes my time to retire from the workforce, I'll be grateful for my medicare. Or is that too socialisticky foryou?

Mary K Kennedy/Blue Summer Daze,I understand the disparity in pay. The problem is your private equal has little work or it is outsourced to India. So you are getting $1600 more than most private sector employees. I might have to modify my numbers. Certainly someone in your grade should do better.

No, Bill, I'm no fan of outsourcing for the sake of lowering the cost of wages, but not everything is, or can be, outsourced. Many things are, but what folks in my line of work, whether public or private, do requires a physical presence in the states. And again, the problem is not that public employees may have pensions, but that private employers have been made free to get rid of them, primarily by the weakening of labor laws.

My husband turned 55 this year and now receives a $3200 a month pension check from the Transit Authority. It's a joint/survivor annuity so we'll get it as long as either one of us is alive. My husband contributed to this fund for 30 years and his employers matched the contribution. The contribution was only a few % of salary, nothing to raise any eyebrows. The fund did so well at one point, the employer stopped contributing entirely for several years (the workers went to court to successfully win back a share of the savings). I don't feel that my husband is receiving some unearned benefit, he paid for it for thirty years; I think every worker in America should have a pension like this. I'm very grateful my husband has these pension benefits, since, I, working in the non-profit sector, will have none at all.In addition, he has free retiree health insurance (also funded through worker contributions and employer matches). It is pretty good insurance, with prescription coverage and a medicare wrap-around. The cost to the benefits fund to cover our family of four is about $850 a month. I won't go into the great childcare benefits we also received before he retired.I, too, think public employees are not the problem; our problem is that every worker in America doesn't also have these same benefits.

Peter - will the Federal gov't CHIP program pick up the slack for this AZ decision?

Jim:No. AZ's CHIP program uses federal funds authorized under the federal CHIP program. Like Medicaid, CHIP is designed to be a shared federal/state responsibility. By shutting down its CHIP program, AZ would forfeit available federal matching funds.

Peter, thanks for that explanation. So next question: does the new health care reform act provide any options to fill the hole left by AZ's unconscionable decision?