Arizona Halts Medicaid Funding for Some Transplant Surgeries

The State of Arizona – facing soaring enrollments and shrinking revenues – has eliminated Medicaid coverage for some transplants of the heart, liver, lungs, pancreas and bone marrow.  Because these treatments are usually considered to be life saving, the consequences for Medicaid patients in Arizona requiring transplantation are grim.  The cut, which impacts approximately 100 Arizonans, is a clear demonstration of the fiscal pressure that states are facing.

“It’s a real sign of the times,” said Alan Weil, executive director of the National Academy for State Health Policy.  “And I think this is a precursor to a much larger number of states having this discussion.”  These policy implications are all the more striking, given the partisan framing of the healthcare debate.  Republican arguments against the Patient Protection and Affordable Care Act frequently focus on the specter of healthcare rationing and even the so-called death panels.  Democrats counter with the argument that – because 50 million Americans currently lack coverage – healthcare is already being rationed.

Diane Rowland, director of the Kaiser Commission on Medicaid and the Uninsured, said that Arizona’s move “is a classic example of making decisions based not on medical need but based on a budget.  It results, potentially, in denial of care to individuals in a life-or-death situation.”  Dr. Robert Gaston, president-elect of the American Society of Transplantation, agrees, noting that “It seems inappropriate that life-saving care has the potential to be withheld based solely on budgetary issues and the bureaucratic determination of relative benefits.”

Earlier this year, Arizona became the only state to almost eliminate its Children’s Health Insurance Program, which would have impacted 47,000 children from lower-income families.  State legislators reversed this decision before the effective date, but only after concluding that the state might lose billions of dollars in matching money from the federal government

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