October 1 is the first salvo Congress and the president fired at Medicaid members. There is much more to come, sadly.
The first bolus of people who will be losing healthcare services lost their health coverage this week.
As Stephanie Innes reported this week Thousands of legal immigrants in Arizona lost AHCCCS last week. She documented that 20,658 legally present refugees, asylees and other legally present immigrants lost their full Medicaid coverage last Thursday.
About 15,000 will still qualify for limited Federal Emergency Services, which pays for emergency medical care but not routine, preventive or ongoing treatment of chronic conditions. Another 5,744 people lose AHCCCS coverage altogether.
These aren’t undocumented immigrants. They’re refugees, asylees, humanitarian parolees, trafficking victims and certain abused spouses and children who are legally present in the United States.
One is a Syrian woman with Stage 4 cancer.
Another is a 9-year-old refugee from the Democratic Republic of the Congo who has epilepsy. His school says he needs his seizure medication to attend school. His family can’t afford his medical care on their own.
These are the kinds of people Congress and the president enthusiastically decided will lose their healthcare.
It Doesn’t Have to be this Way
Federal law has long given states the choice to provide Medicaid coverage to lawfully present immigrant children and pregnant women without making them wait five years.
Arizona never took that option. So some vulnerable Arizona children and pregnant women are more exposed to these federal cuts than they would have been if Arizona policymakers had made a different choice.
People don’t stop getting cancer, epilepsy, diabetes or behavioral health conditions because their insurance disappears. They delay care, skip medications and eventually some end up in emergency departments where care is much more expensive. Hospitals, community health centers and other safety-net providers absorb more uncompensated care.
But there’s something else bothering me that isn’t really about public health.
It’s about compassion.
We can have legitimate disagreements about immigration policy. But these are people our country legally allowed to come here, many after fleeing war, torture, persecution, trafficking and other circumstances most of us have been fortunate enough never to experience.
I’ve spent most of my adult life working in public service in Arizona. It’s profoundly discouraging to watch our public policy become this brutal toward people who have so little political power to defend themselves.
And this is only the beginning.
Starting in January, hundreds of thousands of other AHCCCS members will face new work/community-engagement requirements and twice-a-year eligibility renewals.
Note: Arizona Representatives Andy Biggs, Juan Ciscomani, Eli Crane, Paul Gosar, Abe Hamadeh, and David Schweikert all enthusiastically voted for this policy. Remember that when you vote this Fall.