Andy Biggs is the Republican nominee for governor of Arizona. If he wins, he'll run the state's Medicaid program.
Fifteen years ago, he tried to get rid of it.
In early 2011, then-state Sen. Biggs sponsored Senate Bill 1519. It would have ended the Arizona Health Care Cost Containment System, known as AHCCCS, which is Arizona's name for Medicaid, on October 1, 2011. That's just months after the bill was introduced. The Arizona Mirror dug the plan back up this week, along with what Biggs said to defend it.
Who would have lost coverage
At the time, nearly 1.4 million Arizonans were enrolled in AHCCCS.
Biggs' bill replaced it with a much smaller "safety net" run by the state health department, meant only for the "most needy." The department would get $1.2 billion to design it, "subject to the availability of funding." According to the Mirror, Biggs made it clear his replacement would serve only a fraction of the people on the program.
It wouldn't even fully cover the nearly 100,000 Arizonans with severe mental illness and developmental or physical disabilities who depended on AHCCCS. And Biggs said that was by design. At a February 22, 2011, Senate Appropriations Committee hearing, he explained:
"You can't even cover them, because if you were to cover them, you have no savings."
Of the people who relied on the program, he said:
"What did they do before we built the infrastructure?"
Research gives the answer. When people who need Medicaid can't get it, they are more likely to die.
"Robbed and enslaved"
Biggs framed ending health care for low-income Arizonans as a matter of protecting future generations from debt:
"When we allow the generations in the future to be robbed and enslaved to pay for the healthcare costs of people today, we're not being good stewards. We're allowing the future generation to be placed in bondage."
He also suggested another option: charging people premiums to stay on the program. The problem, he said, was that enrollees didn't "want to pay for it."
Arizona would have thrown away federal money
Here's what the math looked like. AHCCCS cost about $10 billion that year. Arizona paid about $2 billion of that. The federal government paid the rest.
The Legislature's own budget analysts, the Joint Legislative Budget Committee, ran the numbers on SB 1519. According to the Mirror's reading of that analysis, the plan would have saved the state around $1 billion in 2012, while losing Arizona $4.8 billion in federal funding.
In other words, to save one dollar, Arizona would have given up almost five dollars flowing into its hospitals and clinics.
Even Republicans balked
Members of his own party on the Appropriations Committee were highly skeptical of the plan.
Moderate Republican Sen. Rich Crandall said he was certain it would decimate rural hospitals, which get a big share of their budgets from Medicaid patients. Even Republicans who liked the idea of ending AHCCCS, like Sen. Sylvia Allen, said there was no responsible way to do it in a few months.
When hospitals pushed back, Biggs brushed them off:
"The only way you get attention from these folks is to do something draconian, something magnificent, something big and large."
The bill cleared the Appropriations Committee but never got a vote on the Senate floor.
The debt only matters sometimes
Biggs' whole argument in 2011 was the debt. He still talks that way. When the national debt hit $40 trillion in August, he put out a statement blasting "catastrophic unseriousness about reining in government spending."
But when his own party's priorities are on the table, the debt worry goes away.
Last year, Biggs voted for Trump's budget bill, which is projected to add at least $3.7 trillion to the national debt over ten years while cutting Medicaid and food assistance for low-income people. We've written about how that vote, and his vote against restoring Affordable Care Act help, hits Arizona's hospitals and patients.
So in 2011, the debt was a reason to take health care away from disabled Arizonans. In 2025, the debt was no reason to stop a bill that added trillions and cut Medicaid. The common thread isn't the debt. It's Medicaid.
Biggs has also promised to repeal Arizona's income tax, which would erase about a third of the state budget. He hasn't said how he'd pay for it.
Neither the Biggs campaign nor Governor Katie Hobbs' campaign commented to the Mirror.
What the record shows
In 2011, Andy Biggs sponsored a bill to abolish AHCCCS, the Medicaid program that covered nearly 1.4 million Arizonans, and replace it with a smaller program that he said, by design, could not fully cover the roughly 100,000 people with severe mental illness and disabilities who relied on it. Legislative budget analysts found it would have cost Arizona $4.8 billion in federal money to save about $1 billion. Fourteen years later, he voted for a budget bill that cut Medicaid. Now he is asking Arizonans to put him in charge of the program.
Source
Photo: Gage Skidmore/Flickr, CC BY-SA 2.0, via the Arizona Mirror.
