RUBEN GALLEGO su logagonin one nena —- Congress of the Wuited States eeerecsurreen ‘Bouse of Representatives isan marina aaouness ‘Washington, BC 20515-0307 iene Mach 1.2018 Honorable Andy Slavitt ‘Acting Administrator, Centers for Medicare and Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 Dear Acting Administrator Slavitt, ‘As representatives for thousands of low-income Arizona families who ely on Medicaid for access to health care, we urge you to immediatly reject the state's recent waiver request to CMS that would allow the state's Medicaid program to unlawfully tighten eligibility rules that could result in hundreds of thousands of resents losing access to care. This waiver request could cause an estimated 500,000 Arizonans — including over 250,000 childrea —to lose this essential health coverage As you may know, last week, Govemor Ducey signed legislation requiring the state to request waiver authority from CMS to allow the state to implement unreasonable and short- sighted eligibility requirements and lifetime limits on coverage for Medicaid beneficiaries. Governor Jan Brewer vetoed identical legislation last year, stating thatthe proposal would amount to “a breaking point” forthe Arizona health care system. Should CMS approve the ‘waiver request, hospitals and community health centers would be deprived of critical funding they depend on to meet the growing demand for cae in their communities. Urinsured patents ‘will still seek out services in hospitals across the state, and the costs of uncompensated care will strain Arizona's health care providers and contribute to higher overall health cae costs for private and public payers alike. (CMS has previously stated that it has yet to approve any waivers from states that fail 10 “keep faith with the [Affordable Care Act's] goals and consumer protections.” We stand ready to ‘work with you and state officials to seek a balance between providing needed health care for {families and providing states with reasonable flexibility to meet the unique needs of their residents, The state's waiver request, however, constitutes a clear violation ofthe Act's Maintenance of Effort” standard and a decision to reject it would be consistent with CMS's previous actions. For example, your agency has blocked requests by the governors of other states, including Utah and Indiana, who sought to implement similar restrictions on Medicaid eligibility‘The state's waiver request irresponsibly eliminates access to healthcare for our most vulnerable residents, including veterans and children who rely on Medicaid coverage for access to affordable healthcare. We strongly urge you to reject this request. faben Gallego Member of Congress Member of Congress “Member Bf Congress