Update: The implementation date for the "look back" has been extended from July 1, 2021…
Arizona’s governor has proposed an unconventional way to raise money for the state’s economically strapped Medicaid program. Governor Jan Brewer has proposed a fee of $50 to those individuals enrolled in the state’s Medicaid program who are obese or are smokers, and don’t follow their doctor’s orders to get healthy.
Proponents of the fee claim that if the proposal were ratified by the state’s legislature, and the fee was enforced, many service cuts that have been made to balance the budget would be offset, including the revival of coverage of organ transplants.
The Arizona surcharge would apply to childless adults who are obese and those who smoke. Patients that do not meet specified goals according to a personal wellness plan developed with a primary-care physician would be required to pay the $50 fee. At this point, the measure to determine obesity, or whether an obese person is following his or her wellness plan, has yet to be finalized.
While surcharges and higher premiums for unhealthy habits such as smoking have been implemented by private insurance companies, this would be the first time that such fees have been proposed by a state for imposition on recipients of Medicaid. It has been suggested that federal Medicaid rules would prevent the state from enacting such a law, but the law’s proponents believe that federal rules would not apply in this instance.
This type of proposal may soon be mirrored by other states attempting to develop creative ways to balance their budgets. If Arizona is successful in passing this law we may find other states following suit.
While New York State has not sought to impose an obesity fee to date, the recent proposals of the Medicaid Redesign Team reflect a growing concern with Medicaid costs. Your Elder Law attorney needs to be up-to-date regarding the most recent proposals and developments affecting New York’s Medicaid program, in order to assist you with navigating through the program’s ever-changing rules. If you need advice, please feel free to contact Lamson and Cutner.