When Budget Cuts Are Fatal

When Budget Cuts Are Fatal

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At any given moment, thousands of American adults are awaiting organ transplants, hoping for a second shot at life.  But if they’re on Medicaid and they live in Arizona, they’re very likely out of luck. Why? Budget cuts—serious budget cuts at the state level.     

After debating the issue in the legislature this spring, Arizona recently cut funding for organ transplants for about 100 low-income adults who were approved for the procedures. Suspending these transplants will save the state $4.5 million at a time when it’s facing a $400 million deficit in fiscal year 2011 and a projected deficit of about $1 billion in fiscal year 2012, according to Paul Senseman, spokesman for Arizona Governor Jan Brewer

Here’s the crux of the issue and why it’s been getting heated attention in recent days and weeks:  Organ transplants are considered optional by the federal government. And in today’s economic climate, ‘optional’ means endangered. In Arizona, the expenses for transplants are generally covered by the Arizona Health Care Cost Containment System (AHCCCS), or “Access,” as the state’s version of Medicaid is known. But since cash-strapped Arizona is having trouble covering its mandated medical costs—never mind anything else—transplants, among other things, are on the chopping block.

The Governor’s office blames the difficult action, in part, on Obamacare. “We’re stuck,” Senseman told The Fiscal Times yesterday. “We can’t shrink the size of our eligible population. That’s determined in Washington. Medicaid costs as a proportion of our budget have been growing enormously. And I don’t think Arizona is unique in this situation. We would suggest that what you’re seeing in Arizona is what you’re likely to see in many other states in the very near future.”

Others, of course, wonder why organ transplants and not something else.

Another wrenching fact to consider: Some of the folks needing transplants had been approved for a year or more; some were literally about to head into surgery when the cuts were announced. One, Francisco Felix, 32, a father of four suffering from Hepatitis C, which destroys the liver, was told a few weeks ago that a family friend who was dying was donating her liver to him, according to The New York Times. But the slash to the budget meant he no longer qualified for a state financed transplant. When his family tried and failed to raise the needed $200,000, the liver went to someone else on the list. 

“I know times are tight,” his wife, Flor, told the Times. “But you can’t cut human lives.” 

Apparently, you can. (The family is now trying to raise money for a shot at another transplant.)

Last month, an alliance of national organ transplant organizations reached out to Governor Brewer to discuss the transplant coverage issue. “This baseless exclusion of coverage to Arizona citizens represents an actual death sentence for many,” said Maryl R. Johnson, M.D., president of the American Society of Transplantation, in a statement. The first few meetings with the Brewer administration took place in the last two weeks, according to Senseman; more meetings may occur. And next month, when the Arizona state legislature convenes,  Rep. John Kavanagh, a Republican member of the House Appropriations Committee in Arizona, has said he will look into the issue.

Meanwhile, Democratic state senator Leah Landrum Taylor has minced no words. “This [organ transplantation] is not a luxury item. We’re not talking about cosmetic surgery,” she told the Times. “We made it very clear at the time of the vote that this was a death sentence.”

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Maureen Mackey served as managing editor of The Fiscal Times for five years, during which time she oversaw scheduling and work flow and handled edits, writing and reporting of many features, news items, interviews and other content. In 2011 she helped The Fiscal Times win a MIN award for Best New