Arizona Governor Jan Brewer sent a strongly worded letter to Senator Max Baucus protesting a proposed “unfunded mandate” to increase Medicaid eligibility during a time when the state is reeling under the worst financial crisis in its history and is forced to make massive cuts to critical health, education and safety programs. In contrast to the Congressional Budget Office’s (CBO) estimate of $454 million as Arizona’s portion of the Medicaid expansion, the Governor estimates a state cost of $2 billion between 2014-2019 if only half of the estimated 200,000 Arizonans under 100 percent of federal poverty level (FPL) “come out of the woodwork” to enroll.

We believe this to be essentially correct. Mandate coverage, and more people will enroll in Medicaid and other public programs. State costs will continue to rise. Don’t mandate coverage, more people will be uninsured, and more will enroll in Medicaid, as they are doing now. Either way, state costs go up.

What we have here is a serious revenue shortfall, both at the federal and state level. We can’t simply cut our way into the future. Governor Brewer, to her credit, knows this and at least has tried to address the issue. Arizona’s legislative leaders, unfortunately, are in denial. While they wait for the Good Times Train to start rolling again, thousands of citizens will need basic health and human service assistance.