Several years ago SLHI funded a study by the Center for Health Information Research at ASU on the effects of Medicaid disenrollment on health care use and cost. Using 2004 data on both insured and uninsured children in Arizona, the study projected that a 10% disenrollment would increase the cost of care per child by $2,121 annually, due to a shift in care from ambulatory settings to more expensive emergency departments and an increase in hospital days.
Now consider the Governor’s budget proposal to eliminate Kidscare and save the state about $23 million by disenrolling almost 44,000 children. Let’s be wildly optimistic and conclude that half of these children will find coverage somewhere else, leaving the other half without coverage. Using health care costs of almost six years ago, we can conservatively predict additional costs of close to $50 million for the state’s health care providers – more than double what the state “saves” in the general fund. If we used cost data from 2009-2010, of course, the amount would be considerably higher.
Imagine doing a similar analysis for the 310,000 people who would be disenrolled from Medicaid under the Governor’s budget, or the approximately 17,000 adults who would be impacted by eliminating funding for the Arnold v. Sarn lawsuit. And so on.
If you think hospitals, community clinics, nonprofit agencies and other providers of health and human services are at the edge now, just wait. It’s cost shifting on steroids. It’s unfair, ineffective and inefficient – and that’s just for starters.
But the Governor is right about one thing: If someone has a better plan to eliminate the state deficit and offer “real solutions” to the problems facing the state today and into the foreseeable future, they should come forward. Carping from the sidelines won’t cut it. Get involved.