Arizona Mulls Fee for Smokers, Overweight

Medicaid recipients in Arizona who smoke or don’t follow doctor’s orders to lose weight could be fined, in effect, under a proposal before the state legislature, the Wall Street Journal reports. Republican Gov. Jan Brewer proposed a $50 fee on some enrollees in the state’s healthcare fund for the poor if they persist in unhealthy behaviors.

Gov. Jan Brewer

"If you want to smoke, go for it," said Arizona Medicaid spokeswoman Monica Coury. "But understand you're going to have to contribute something for the cost of the care of your smoking."

Brewer proposed the idea to help the state’s depleted Medicaid program raise new funds, restore coverage of organ transplants — which had been rescinded as a cost-saving measure — and lessen proposed cuts in enrollment.

The fee would go into effect Oct. 1 if the Republican-led Legislature passes it, and would apply only to childless adults who don’t meet targets for improved health set by their primary-care physicians.

Such a Medicaid fee might need authorization from the Centers for Medicare and Medicaid Services in Washington. No such levy has ever been approved, an agency spokeswoman said.