Health-care law: Arizona tries new approach to get by federal Medicaid rules

From N.C. Aizenman of The Washington Post on Jan. 23:

Republican efforts to repeal or limit the reach of the new health-care law took a new direction last week when Arizona lawmakers approved a novel and controversial attempt to cut Medicaid for 280,000 of the state's poor.

The bill, requested and signed by Gov. Jan Brewer (R), empowers her to make a formal request, most likely this week, for a federal waiver to avoid complying with provisions of the law that prohibit states from tightening their eligibility requirements for Medicaid.

Twenty-nine Republican governors, including Brewer, have signed a letter calling on President Obama and congressional leaders to remove the provision from the law.

But Arizona is the first state to, in effect, play chicken with the Obama administration by directly requesting a reprieve and daring Health and Human Services Secretary Kathleen Sebelius to refuse.

The move is widely regarded as a long shot. While a spokesman said the White House had no comment on Arizona's request, administration officials have shown scant interest when asked about the idea in the past.

Still, Arizona's move reflects two pressing realities: Many states face large budget shortfalls because of continuing economic difficulties, and Republican governors point to Medicaid cuts as one of the most logical ways to balance those budgets.

"The effect of federal requirements [in the new law] is unconscionable," the Republican governors wrote in their letter earlier this month. "States are unable to afford the current Medicaid program, yet our hands are tied."

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