The budget is not just a list of appropriations. It also includes budget reconciliation bills, or BRBs. These bills amend state law that are connected to the budget.
The healthcare BRB has a long list of AHCCCS eligibility directives. Some are reasonable efforts to improve accuracy. Others will just create more administrative barriers for eligible members.
Here’s the condensed version of AHCCCS’ new responsibilities in the Health BRB. AHCCCS must:
- check lottery and gambling winnings, including online gambling winnings, when deciding eligibility.
- review death records, wage changes, employment information, unemployment benefits and evidence that a member may have moved out of state.
- review a member’s eligibility whenever it receives information suggesting that the person’s circumstances may have changed.
- not accept a person’s statement that they live in Arizona without independently verifying residency.
- may accept eligibility assessments from the federal health-insurance marketplace, but it must independently verify the information and make its own eligibility decision.
- may enter into agreements with other state agencies and contract with outside vendors to obtain more eligibility information.
- submit any necessary federal waiver requests to CMS by April 1, 2027.
Some of these data checks make sense. AHCCCS shouldn’t enroll someone who died, moved out of state or won the lottery. But… every added verification requirement creates another opportunity for an eligible person to fall through the cracks, especially the provision that they can’t accept a person’s statement that they live in Arizona without independently verifying residency.
Hospital Presumptive Eligibility Narrows
The healthcare BRB also directs AHCCCS to ask the federal government for permission to narrow hospital presumptive eligibility.
Presumptive eligibility allows hospitals to temporarily enroll patients who appear eligible for AHCCCS while their full application is being processed. The BRB would limit that pathway primarily to only kids and pregnant women.
Dementia Planning and Newborn Screening
ADHS also got $700K for an Alzheimer’s disease and related dementia initiative. ADHS would become the lead state agency for dementia planning, coordinate programs across state agencies, engage stakeholders and regularly update Arizona’s Alzheimer’s Disease State Plan. There are a lot of details but $700K looks stingy for what they’re expected to do.
The budget also gives the state lab $755K in new money to add Duchenne muscular dystrophy to Arizona’s newborn screening panel (without needing to raise the newborn screening fees).
If you want to get more details, you can look at the following links:
