Arizona voters narrowly rejected a state constitutional amendment that would have banned laws restricting choice of health plans or mandating that people obtain coverage. The amendment would have been at odds with certain elements of President-elect Obama's health care proposal. Of 1.8 million votes, 50.2 percent voted against, and 49.8 percent voted for, the amendment.
Sponsored by the group Medical Choice for Arizona, Proposition 101 was championed by two local physicians and conservative anti-tax groups and supported by some provider associations. Supporters claimed that Proposition 101, known by advocates as the 'Freedom of Choice in Health Care Act,' was needed to guard against a mandatory single-payer system and ensure patient freedom to make choices about their coverage.
Opposition was led by the Arizona Coalition for a State and National Health Plan, a group chaired by two Arizona physicians. It was also opposed by Governor Janet Napolitano, hospital and business groups, and some physician associations. They argued that the amendment could increase costs and the number of uninsured by putting the state's Medicaid managed care program at risk. The director of the Arizona Health Care Cost Containment System (AHCCCS), which runs the state's Medicaid and indigent programs, released a letter on September 17 saying that Proposition 101 could lead to requiring AHCCCS to switch from a managed care to fee-for-service model, increasing state costs by up to $2 billion per year.
References [1] Montana SCHIP enrollment was 17,240 and Medicaid enrollment for children was 46,645 in November 2008. Approximately 31,000 (14%) of all Montana children are uninsured according the 2008 U.S. Census Bureau Current Population Survey, based on the three-year average (collected 2006-2008).
[2] The eligibility cut-off between Medicaid and SCHIP will depend in part on the details of the SCHIP reauthorization by the U.S. Congress, expected in early 2009.
[3] The SCHIP expansion applies only to children not covered by private insurance for at least three months, ineligible for Medicaid, and who are U.S. citizens or qualified aliens and state residents. The plan stipulates that eligibility may be reduced if funding is insufficient.
[4] Enrollment is frozen, except for new dependents for existing members, new workers for currently participating employers, and applicants who do not need subsidies. About 11,000 members and 621 small groups are currently enrolled.
[5] 64.3% of referendum voters chose "Yes" to veto Public Law 629, legislation enacted in June 2008 that amended the Dirigo Health Program statute to replace the Savings Offset Payment with funding from 1) a health access surcharge of 1.8% on paid insurance claims; 2) an increase in excise tax on malt beverages and wine; and 3) a new tax on syrup for soft drinks and bottled soft drinks. According to Riley, the legislation reflected a compromise developed over four years of negotiations.