What is AHCCCS? (pronounced “access”)

AHCCCS is Arizona’s Medicaid program. The Arizona Health Care Cost Contain System has been an innovative Medicaid program, despite the fact that Arizona was the last state in the union to participate in Medicaid.  In 1982, the Arizona legislature finally agreed to take federal money to provide healthcare for its poorest citizens.  But Arizona did something very different from other states and became a model for the nation.

AHCCCS was set up as a public-private partnership through which the state paid companies a capitated amount of money to manage the health care of people in the AHCCCS system.  This continues today as each person enrolled in AHCCCS is assigned an HMO health plan. Each person in AHCCCS must have a primary care physician who refers them to specialists and lab tests they may need.

The federal government currently pays about three quarters of the cost of AHCCCS and the state pays for the rest. Under Obamacare, the federal government will pay for 100% of the cost of expanding AHCCCS from 2014 – through 2017.  After that, the feds will pick up 90% of the Medicaid tab.

People whose income is below 133% of the federal poverty level will able to sign up for AHCCCS starting in October, and their benefits will begin on January 1st 2014. Each person will be assigned a AHCCCS HMO plan and there will be no co-pays for medical services.

There should be quite a scramble to find and convince 300,000 people across Arizona they can get free health care through AHCCCS.

Hospitals throughout Arizona will play a big role in enrolling people in AHCCCS. I have heard stories of past years when people who ended up in the hospital without health insurance would get signed up for AHCCCS on the spot. That was before 2011 when the rules for AHCCCS eligibility were tightened.  Now Arizona hospitals will get paid for the services they provide to poor people – unless they make more that 133% of the FPL.

 

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