Federal officials on Friday poured cold water on Arizona House Speaker Andy Tobin's plan to force Medicaid recipients to get a job and to limit their insurance to a maximum of five years, saying the proposals likely run counter to federal law and won't be approved.
Tobin is pushing the proposal as a way to ensure that able-bodied people aren't depending on the government for assistance when they can seek work. He also says the five-year cap is not unfair, comparing it to limits on welfare and unemployment insurance.
But the proposal requires a waiver from the federal government, and that's extremely unlikely, said Emma Sandoe, a spokeswoman for the Centers for Medicare & Medicaid Services.
"While we want to work with states to provide state-based solutions to improve the Medicaid program, we believe that Arizona's proposal likely runs counter to Medicaid's law and regulations," Sandoe said in a statement provided to The Associated Press.
Tobin said Friday that he wasn't discouraged by the indication that the federal government likely won't approve his plan.
"Things are always changing back there," he said, noting ongoing revisions to rules for President Barack Obama's health care overhaul rollout.
Tobin's proposal was approved Thursday by a House committee dominated by fellow Republicans. The same committee approved a plan by Rep. Adam Kwasman, R-Oro Valley, to repeal last year's expansion of Medicaid, but that bill has no chance of becoming law because of opposition from Democrats, some Republicans and Gov. Jan Brewer.
Both Tobin, R-Paulden, and Kwasman are running for the Republican nomination in Arizona's 1st Congressional District.
Tobin said Thursday that he would not support Kwasman's proposal, calling it "a fool's errand" to refight a giant battle that conservative Republicans lost last year after Brewer put together a coalition to push it through the Legislature.
Tobin's proposal also includes a requirement for a co-pay for unnecessary visits to hospital emergency rooms. The federal government had been allowing Arizona to charge $30 co-pays for unnecessary emergency room visits, but that expired Dec. 31. Arizona is now asking federal officials for authority to charge $200 for such visits for newly eligible people on the state's Medicaid plan, called the Arizona Health Care cost Containment System, or AHCCCS.
"They didn't like co-pays either," Tobin said of a fight to institute the $30 fees in recent years. "We have an election coming up. Maybe they will reconsider their options when they see their numbers."
He called his proposal a reasonable effort to try to put state limits on the expansion of "Obamacare" and develop ways to reduce the cost of providing health care for the poor.
Tobin's proposal would affect even those who have full-time jobs but qualify for free health care because they earn so little.
"The idea is to say hey, after five years, is not 60 months long enough?" Tobin said after Thursday's committee hearing on House Bill 2367. "Cash assistance is two years, unemployment has limitations, this is double, more than double what the cash assistance is."