Arizona Medicaid cuts include transplant funding

A Phoenix man awaiting a bone-marrow transplant got good news Friday - word of two donors who are possible matches.

But new budget cuts for Arizona's Medicaid program also take effect Friday, and they eliminate coverage for many types of transplants, including the lifesaving one Mark Price needs.

The former armored-truck guard with leukemia would normally receive a transplant within a few weeks if tests of the donors and Price's continuing therapy go well, said Dr. Jeffrey Schriber.

"Unfortunately we can't do that now," said Schriber, director of the Blood and Marrow Transplant Program at Banner Good Samaritan Medical Center.

Price is now left hoping that the state can reverse the cutbacks.

"We need to save lives and knowing the funding is not there for me - it's pretty hard to deal with," he said in an interview. Price's need for a transplant was reported Tuesday by the Arizona Guardian, an online news site.

The benefit cuts implemented Friday by the Arizona Health Care Cost Containment System, known as AHCCCS, were included in the budget the Legislature and Republican Gov. Jan Brewer approved last spring.

Transplant centers have been lobbying the Republican-led Legislature in recent months to agree to meet in special session to at least temporarily restore the transplant funding, but so far there is no indication that any action is coming.

A spokesman for Brewer said the state faces huge cost burdens from federal mandates about who is eligible for the Medicaid program, so it has been forced to cut optional services such as transplants.

"This spending cut was made literally as a last resort," spokesman Paul Senseman said.

Besides bone-marrow transplants involving non-relatives, coverage for lung transplants and some heart and liver transplants has been eliminated.

Also eliminated is coverage for occupational and speech therapy, insulin pumps, hearing aids and emergency dental care. There's also no more funding for wellness exams, but mammograms, pap smears and colonoscopies remain covered.

Arizona faces continuing budget troubles. State budget analysts this week predicted the state's $8.5 billion budget will face a midyear shortfall of up to $825 million as the still-ailing economy produces less tax revenue than expected.

Medicaid coverage varies widely among states, but there has been no evident trend that the many states struggling to balance their budgets are slashing transplant coverage, said Laura Tobler, a National Conference of State Legislatures program analyst in Denver.

Arizona's cut of optional services will save about $5 million for the fiscal year that started in July, said Jennifer Carusetta, an AHCCCS spokeswoman. An additional $15 million of federal funding provided on a 3-to-1 matching basis will be lost.

The reductions in transplant coverage means deaths "could be a possible outcome if somebody is unable to obtain a transplant," she acknowledged. "You can't take away a benefit without somebody being affected."

Carusetta said the cutbacks could affect up to 100 people who may need transplants, but only about 15 percent of patients are likely to get a transplant in any event. Schriber estimated AHCCCS has funded five to 10 bone-marrow transplants a year. The procedure can cost $250,000 or more, he said.

"But if they're in the situation like Mr. Price, those are people who have no options," Schriber said. "They will die without this."

House Appropriations Chairman John Kavanagh said the cuts were troubling to make but "quite limited and quite targeted," specifically not affecting transplants for children. "Nobody likes to take away need-to-have services," he said.

Kavanagh, a Republican, also said legislative aides are reviewing claims that non-relative bone-marrow transplants work better than lawmakers believed when they approved the cuts. "We were told they were totally ineffective," he said.

The cutbacks drew fire from Democrats.

Attorney General Terry Goddard, the Democratic nominee for governor, said Tuesday that Brewer "hasn't made tough decisions; she's made mean decisions that hurt Arizona families."

Democratic Rep. Chad Campbell appropriated former Alaska Gov. Sarah Palin's criticism of the federal health care overhaul. "The only real death panel is in AZ. It's called the Legislature," he said Friday in a Twitter message.

Senseman said the Democrats' criticism was "absolutely shameful" because they were seeking "political gain" without offering their own budget solutions.