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Arizona Narrowly Rejects Ban on Coverage Mandates and Choice Restrictions

Arizona voters narrowly rejected a state constitutional amendment that would have banned laws restricting choice of health plans or mandating that people obtain coverage. The amendment would have been at odds with certain elements of President-elect Obama's health care proposal. Of 1.8 million votes, 50.2 percent voted against, and 49.8 percent voted for, the amendment.

Sponsored by the group Medical Choice for Arizona, Proposition 101 was championed by two local physicians and conservative anti-tax groups and supported by some provider associations. Supporters claimed that Proposition 101, known by advocates as the 'Freedom of Choice in Health Care Act,' was needed to guard against a mandatory single-payer system and ensure patient freedom to make choices about their coverage.

Opposition was led by the Arizona Coalition for a State and National Health Plan, a group chaired by two Arizona physicians. It was also opposed by Governor Janet Napolitano, hospital and business groups, and some physician associations. They argued that the amendment could increase costs and the number of uninsured by putting the state's Medicaid managed care program at risk. The director of the Arizona Health Care Cost Containment System (AHCCCS), which runs the state's Medicaid and indigent programs, released a letter on September 17 saying that Proposition 101 could lead to requiring AHCCCS to switch from a managed care to fee-for-service model, increasing state costs by up to $2 billion per year.

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