Apr 172013

By Naomi Hatch
After a great deal of discussion, the Snowflake Town Council tabled Resolution No. 13-04 supporting Governor Jan Brewer’s Medicaid plan April 9. They will revisit the issue on Tuesday, April 23.
Summit Healthcare Regional Medical Center officials had asked the town to support the governor’s plan through a resolution to state legislators.
Summit has been greatly affected by the elimination of Prop. 204, according to Summit CEO Ron McArthur. He pointed out that Summit’s gross revenue is $353,928,394 with salaries and benefits at $67,919,906 for 928 employees. He noted that Medicaid revenue hospital-wide represents 23 percent of that and that 73 percent of baby deliveries at the medical center are paid by Medicaid. McArthur said that 47 percent of Summit’s deliveries involve unwed mothers, noting, “We’ve got a big problem on the mountain.”
Vice Mayor Jason Whiting conducted the meeting, and asked that speakers be limited to two in favor of the plan and two opposed, rather than have several speakers discuss the same issues.
Cindy Schreiber, president of the Silver Creek Senior Citizens Center, represented area seniors, noting that they had discussed the issue and asked her to represent them.
“We have people that are struggling,” said Schreiber, who noted that often seniors are doing without medications in order to survive month to month. “The new coverage will let them live off the fixed income they have without seeing the impact. They feel this program will be good, because they feel they will qualify under the program offered.
If Brewer’s plan is not approved, 50,000 to 60,000 childless adults in Arizona will lose coverage on Jan. 1, 2014, even if they are in the middle of treatment.
Becky Gibson represented those present who oppose the plan. She pointed out speaking points from the Goldwater Institute and Navajo County District III Supervisor Sylvia Allen stating the plan will cost Arizona millions of dollars. “I’ve never seen any federal program that doesn’t cost the citizens money,” she said, noting that reimbursement would come from the federal government, and can be withdrawn at any time. “The federal government already said they will probably have to cut the promised reimbursement rate.”
“The provider tax that the state is going to levy will create a new bureaucracy,” Gibson continued, asking who is going to levy taxes to provide the funding and who is going to enforce the plan, pointing out that these people would not be elected to office. She went on to say that we have seen the cost increases that came with Obamacare.
Referring to the statement saying this would create jobs, Gibson asked, “Is it ever really a job creation when it comes through the federal government? I don’t believe there is ever such a thing as free federal money,” noting that she would not like to see the community support an increase in taxes and another bureaucracy.
“I would like to see that our community isn’t going to say we’re going to pass it because Gov. Brewer wants a new tax; this is Obamacare and I don’t think Obamacare is good for our country,” said Gibson.
McArthur explained the proposal is to restore Proposition 204 funding that was voter approved twice, and stated, “This has nothing to do with Obamacare,” noting it was voted on two years before Obamacare.
At the beginning of this discussion, Councilwoman Bev Kay asked the rest of the council, “How many council people were aware of this and actually studied the issue themselves?”
Whiting, and Councilmen Tom Poscharsky, Kerry Ballard, Stuart Hensley and Chris Brimhall all raised their hands.
“I haven’t studied this as much as I could,” said Kay. “I’ve always been impressed with Gov. Brewer for opposing Obamacare.”
Gibson responded, “I don’t think we ever get federal money without strings and federal regulations. You’re giving up control any time you take federal dollars.”
Kay asked if anyone knew why the legislators were against the plan, but no definite answer was given.
Poscharsky pointed out that most other states had decided to take it.
McArthur noted that only Arizona, Hawaii and Alaska did not approve it.
Gibson expressed concern that this would be socialized medicine.
“I think we’re already doing it (socialized medicine), because if these people don’t get funding from the state, when they get sick they go to ER and have to be treated anyway,” said Ballard. “What do we do?”
“Those childless adults use ER as their primary provider,” said McArthur noting Summit had a $7.4 million bottom line taken away to help the state balance its budget. He said that now the state has a surplus and Gov. Brewer is trying to restore $5 million in payments back to Summit. “Our bad debt is growing,” he continued, explaining that it grew nearly $5 million in 2011-12. “We can’t continue to eat that.” McArthur said that if this doesn’t pass, Summit officials will have to look at their biggest service and that is obstetrics.
McArthur pointed out safeguards in the plan, which they call circuit breakers, explaining that it protects the state if federal matching rates drop below 80 percent as the state would have the option to opt in and out of the program at any time.
He further explained that Arizona families are paying nearly $2,000 more in premiums annually due to uncompensated care, and that the hidden tax hurts Arizona families and business, making them uncompetitive.
“The provider tax is not a tax to the citizens,” explained McArthur. “The hospital community is willing to put up a provider fee to get matching dollars from the government.
“I know of no hospitals in the state that are opposed to it,” he continued, noting there are a number of hospitals whose financial survival is dependent on this passing, especially those in southeast Arizona. He said that 20 percent of our citizens are without health insurance.
Gibson said that they did not want to lose the hospital, noting, “I believe these tie up to Obamacare…I think we need more information for the city before we send this resolution.”
Brimhall noted that he had the same information as Gibson from the Goldwater Institute, and stated, “It’s not something that we can’t do in the future as we see other states’ experiences with it.”
Ballard said he could see good and bad on both sides, noting he didn’t want more taxes, but didn’t want to see the hospital go away.
“We’ve already lost one large employer in this area,” pointed out Cathy McDowell, who said she felt that people would move if there wasn’t a hospital here, and “that’s 900 jobs on the mountain.”
“No one likes extra taxes, but we’re all involved in the system,” said Poscharsky adding that he thought a vote on this needs to happen soon, not be put off.
“My concern is lack of knowledge,” said Kay. “I don’t feel like I’ve received enough information to vote for it because we’re representing the whole town of Snowflake. How can I vote when I don’t feel comfortable in the knowledge I’ve received on either side?”
Hensley agreed with Kay.
“This hospital is not planning to close, but we may close OB,” clarified McArthur.
Whiting asked town staff members to contact legislators to see why they are opposed to Brewer’s plan and also get more information from the governor’s office.
A motion to table the item for two weeks to allow time to get more information on the issue passed unanimously.