Healthy Prognosis 

Can't afford health insurance? By the end of the year, the state may have you covered.

STATE OFFICIALS ARE ALREADY working to implement Prop 204, the Healthy Arizona initiative passed by voters last November.

Funded through the $3.2 billion Arizona expects to receive over the next 25 years as the state's share of the tobacco suit settlement, the program expands health insurance through the Arizona Health Care Cost Containment System (AHCCCS) to an estimated 380,000 Arizonans who live under the federal poverty level.

State Sen. Andy Nichols, who helped draft the initiative, says that he hopes to bring coverage to the first eligible group by April. A second group should be signed up by July and the last by October. Once that's done, Nichols says the program allows any remaining money to be used for premium sharing for people earning up to 200 percent of the poverty level, although they will need to provide a co-pay.

Nichols says there are two potential roadblocks:

· The federal government will provide matching funds for the program, but the state must first seek a waiver that shows budget neutrality. Gov. Jane Dee Hull said last week she was hopeful the issue would be resolved before the Clinton Administration leaves Washington on January 20. If that can't be done, she says she's hopeful the state can swiftly work out a deal with the incoming Bush administration.

Nichols says the law requires the state to fund Healthy Arizona 2 even if it doesn't receive federal matching money, so if the state fails to get a waiver, implementing the program "will be costly to the state."

· Several counties have sued the state, claiming a portion of the tobacco tax revenue as reimbursement for the healthcare costs they have incurred over the years. While the counties have won the most recent legal battle, Nichols expects the counties will eventually cut a deal with the state, but he adds that "as long as that's out there in the courts at all, it becomes an issue."

Nichols says Hull is pushing to put a five-year hold on six other programs created by Healthy Arizona 2, allowing the full financial impact to become evident. But Nichols says the legislative budget will fund the programs.

"All six programs that are in 204 are in the joint legislative budget committee's budget and there is a full expectation that they will be implemented by the first of July," says Nichols.

Those additional provisions include programs for disease research, prenatal care and preventing teen pregnancy, and state funding for nutritional programs such as Women, Infants and Children (WIC). There is also a rural health program providing medical scholarships for people outside towns and cities. "That's near and dear to my heart," says Nichols, who heads up the UA's Rural Health Office.

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