Life or death consequences for dozens of Arizonans are butting up against the state's budget woes as legislators debate the elimination last fall of Medicaid coverage for some transplants - even as they consider additional health care cuts.
Some Arizona Democratic lawmakers have introduced bills and held news conferences with transplant candidates to call for reversal of a budget cut that eliminated coverage for some transplants last fall. They also raised the politically charged issue at a legislative hearing Wednesday, for the second day in a row.
The change eliminated coverage for approximately 100 candidates for four types of transplants and saved a projected $1.4 million in the current budget. The state's Medicaid program will still pay for a projected 85 transplants this year, down from 100 before the cut.
"I'm a human life. They seem to be picking and choosing who's going to live and who's going to die," said Mary Lou Estrada, a 62-year-old former electronics assembly worker who needs a live transplant. "It just seems they would put a life before other things."
Majority Republicans and Gov. Jan Brewer show no sign of reversing the cut. In fact, they're moving toward dropping Medicaid coverage for 280,000 adults to help close another shortfall.
Two people among those taken off transplant lists have died since the cut. One of the deaths has been attributed to the cut. The second involved a man who died during preparations for a transplant that was to have been funded through an anonymous donor's contribution.
Said Sen. Leah Landrum Taylor, D-Phoenix: "These are not numbers. These are people."
Senate Appropriations Chairman Andy Biggs, R-Gilbert, said he's well aware of the "tragic consequences" of the transplant cut that took effect Oct. 1. But the budget remains out of whack, with Brewer proposing $600 million of new borrowing to help close a projected $1.1 billion shortfall, so adding new spending to restore the transplant coverages eliminated last year is hard to contemplate, Biggs said.
"Don't think that anybody doesn't think that's not a serious issue," he said. "By the same token, because we're dealing with a zero-sum budget issue, when you move those dollars over here you're taking them from somebody else who also has serious issues. That happens any time you have socialized medicine," Biggs added. "You end up rationing health care."
Brewer spokesman Matthew Benson denied that the governor or her aides have asked that transplant coverage bills not be considered.
"What the governor is looking for is a solution to what is a $1 billion problem," Benson said. "Unfortunately, the Democrats haven't been interested in providing actual solutions to the entirety of the problem."
Rep. Anna Tovar, a Tolleson Democrat who herself is a past bone-marrow transplant recipient, said the issue should be dealt with immediately, not later.
"This small issue has been here since last year and it's not going to go away any time soon. By continuing to ignore the issue, there's definitely going to be more people getting more sick and eventually die," Tovar said.
During the hearing Wednesday, the director of the state's Medicaid program said the decision to end coverage of bone-marrow transplants involving unrelated people was based on a finding that all but one of 14 Medicaid patients who got those transplants died within two years.
State officials since have reviewed data submitted by transplant organizations and surgeons, Director Tom Betlach said.
"We have not seen anything that leads us to change what our two years of results are for unrelated bone-marrow transplants."
Democratic Rep. Matt Heniz, a physician from Tucson, said during the Wednesday hearing that the state should take heed of national studies that involved more people and found higher survival rates.
House Appropriations Chairman John Kavanagh, R-Fountain Hills, said relying on the state's figures on Medicaid enrollees in Arizona was appropriate.
"Almost everybody died. That's powerful stuff statistically," he said.