{"id":448609,"date":"2010-03-19T14:51:08","date_gmt":"2010-03-19T18:51:08","guid":{"rendered":"http:\/\/www.theatlantic.com\/business\/archive\/2010\/03\/arizona-kills-schip-puts-medicaid-on-a-diet\/37764\/"},"modified":"2010-03-19T14:51:08","modified_gmt":"2010-03-19T18:51:08","slug":"arizona-kills-schip-puts-medicaid-on-a-diet","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/448609","title":{"rendered":"Arizona Kills SCHIP, Puts Medicaid on a Diet"},"content":{"rendered":"<p>On the eve of the possible passage of a health care bill, Arizona has provided a glimpse of our possible future by <a href=\"http:\/\/www.nytimes.com\/2010\/03\/19\/health\/policy\/19arizona.html\">shutting down its SCHIP program and booting a bunch of people out of Medicaid<\/a>:<\/p>\n<div><\/div>\n<div>\n<blockquote><p>The Arizona budget is a vivid reflection of how the fiscal crisis afflicting state governments is cutting deeply into health care. The state also will roll back Medicaid coverage for childless adults in a move that is expected to eventually drop 310,000 people from the rolls.<\/p><\/blockquote>\n<\/div>\n<div>The reason this is so troubling, of course, is that the new proposed health care plan gets about half of its coverage expansion through adding people to Medicaid. &nbsp;The state side of this expense doesn&#8217;t show up on the books as a government expenditure (neatly enabling the bill to get a lower CBO score), but someone in America has to be taxed to pay for it, and there is a big problem when tax revenues fall short of the required expenditure.<\/div>\n<div><\/div>\n<div>There are two frightening possibilities, for people who support this bill (and the rest of us, as well . . . but we&#8217;ve been frightened for a while)<\/div>\n<div><\/div>\n<div>1) &nbsp;States pull out, and coverage drops<\/div>\n<div>2) &nbsp;States don&#8217;t pull out, and they go bankrupt.<\/div>\n<div><\/div>\n<div>The third, and to me the most likely scenario, is that the Federal government basically bails out the states, perhaps taking over Medicaid. &nbsp;But that&#8217;s its own problem, because taking over the Medicaid obligations is not going to come attached to any revenue stream to pay for it. &nbsp;Where are we going to get the money?<\/div>\n<div><\/div>\n<div>Of course, that&#8217;s what I want to know about the whole thing. &nbsp;But this makes the problem much more vivid.<\/div>\n<p><br clear=\"both\" style=\"clear: both;\"\/><br \/>\n<br clear=\"both\" style=\"clear: both;\"\/><br \/>\n  <a style='font-size: 10px; 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