Arizona Budget Cuts Put Some Organ Transplants Out of Reach

Nov. 18, 2010— -- Randy Shepherd is a 36-year-old father of three who needs a transplant to replace a failing heart weakened by childhood bouts of rheumatic fever. When he was placed on a transplant waiting list last year, the prospect of resuming a normal life with a healthy donor heart helped him tolerate the fatigue, lost appetite and the inability to play sports he loved and work at the small plumbing business he founded.

But nothing prepared him for the shock of learning that Arizona's Medicaid program was eliminating transplant coverage for people with his condition.

"They said I would be placed on the inactive list until I could arrange some kind of alternative financing because it is considered elective surgery," said Shepherd, of Mesa, Ariz., who has been disabled for almost two years. The family hangs on financially with his wife Tiffany's salary as a dental hygienist.

As the United States continues debating expanded health care access, the state of Arizona has begun rationing some care it says it cannot afford to give its poorest residents. Beginning on Oct. 1, Arizona's Medicaid program, the Arizona Health Care Cost Containment System, stopped covering seven types of organ transplants, including heart transplants for non-ischemic cardiomyopathy, lung transplants, pancreatic transplants, some bone marrow transplants and liver transplants for patients with hepatitis C.

The reductions made by the Arizona state government were approved by the federal government, according to an Aug. 11 letter from Gloria Nagle, associate regional administrator for the Division of Medicaid & Children's Health Operations. In addition to limiting organ transplants, Arizona also restricted coverage of prosthetics and zeroed out podiatrists' services, preventive dental services, and wellness and physical exams for adult Medicaid enrollees.