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Bill limiting Medicaid to 5 years sent to Arizona Gov. Jan Brewer

PHOENIX -- A proposal that could force able-bodied Medicaid recipients to get a job is on its way to Gov. Jan Brewer for consideration.

The House gave final approval to Republican House Speaker Andy Tobin's bill Thursday. The bill would also limit some recipients to a maximum of 5 years of insurance.

House Bill 2367 required the state's Medicaid program to apply for a waiver from federal regulators every year to allow it to impose the new rules. Federal officials at the Centers for Medicare and Medicaid Services reiterated Thursday that the work-rule and time-limit proposals may not be approved because they likely run counter to Medicaid's laws and regulations. Tobin, however, has said he believes Medicaid's position could change.

Tobin's bill also imposes copays on unneeded ambulance and emergency room use. He has said the rules are needed to protect the state from excess expenses. Democrats argue they would limit the effectiveness of the health system for poor Arizonans.

The bill passed both the Senate and the House on party-line votes, with majority Republicans in support and Democrats opposed.

There was little discussion during the final vote Thursday.

As originally introduced in February, the bill would have a hard limit of five years for anyone getting Medicaid. After an outcry from Democrats over its effect on the working poor, Tobin changed that provision and it now only affects people who are able-bodied and don't work. He also added exemptions for pregnant women, those on disability and those caring for young children.

Tobin, R-Paulden, said the federal opposition could change and the requirements give the state tools to cut enrollment if the government fails to fund the program as promised.

"Clearly, these dollars are going to end up on the backs of the states," he said last month. "All we're doing is saying let's request every year the opportunity for some of these waivers."

Tobin's proposal includes a requirement for a copay for unnecessary visits to hospital emergency rooms or ambulance use. The federal government had been allowing Arizona to charge $30 copays for unnecessary emergency room visits, but that expired Dec. 31. Arizona is asking federal officials for authority to charge $200 for such visits for newly eligible people on the state's Medicaid plan, called the Arizona Health Care Cost Containment System, or AHCCCS.

A Medicaid-expansion proposal pushed by Gov. Jan Brewer last year led to a fracture among fellow Republicans. She finally broke an impasse by calling a special legislative session.

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