READ: Part Of Brewer's AHCCCS Plan Includes Fee For Obese, Diabetics, Smokers; This Could Get Interesting

The Wall Street Journal broke the story today that Governor Jan Brewer's new request for waivers from the federal government includes $50 levies on obese enrollees who do not follow a doctor's regimen, and similar fees for similarly-situated diabetics and smokers.

Here is the wording in the Arizona's request to be the first state Medicaid program using such a behavior-oriented penalty:

In addition to flexibilities to assess eligibility, the State is seeking to pilot penalty and

incentive strategies that would assist the State in partnering with the consumers to
take responsibility for their own health care. For instance, all smokers enrolled in the
childless adult population would be required to pay an annual fee of $50. In addition,
childless adults who are obese and/or suffer from a chronic disease, such as
diabetes, will need to work with their primary care physician to develop a care plan.
Individuals who do not adhere to the plan and meet specified goals will be required
to pay an annual fee of $50.

AHCCCS will combine these annual fees with incentive strategies, including those
grant opportunities outlined by the Affordable Care Act, to provide appropriate
incentives for healthy behaviors and disease management. AHCCCS has solicited
input from the public regarding these strategies and will work with stakeholders on an
initiative that best meets the agency’s goal of improving health outcomes and
lowering the cost of care. In addition, the Arizona Department of Health Services
has obtained a $400,000 grant from the Centers for Disease Control and National
Center for Chronic Disease Prevention and Health Promotion, which will be aimed at
wellness initiatives for the Medicaid population. (State's letter to HHS Secy Sebelius, March 31, 2011)

This could get very interesting.


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