Arizona Gov. Jan Brewer has an idea for how to raise money for the state’s Medicaid program: charge obese people and smokers. Brewer’s proposal would require smokers or obese people who don’t follow a doctor’s weight loss program to pay a $50 fee if they are enrolled in Medicaid. If approved, it would be the first time Medicaid has charged people for unhealthy behavior, the Wall Street Journal notes. The revenue would offset recent cuts to the program, and could reverse last year’s limitation of organ transplants.
“If you want to smoke, go for it," says a spokesperson for Arizona’s Medicaid program. "But understand you're going to have to contribute something for the cost of the care of your smoking." One Democratic state senator called the proposed fee unfair. "If someone is obese because they're severely disabled or can't exercise, we shouldn't be punishing them," she said. Under Brewer’s proposal, childless adults who smoke or are obese or chronically ill would be required to work with a doctor to develop a plan to improve their health. The fee would be levied upon those who don’t meet specified goals. Of course, such a fee will likely require authorization from Washington’s Centers for Medicare and Medicaid Services, and a spokesperson for that agency says no such levy has ever been approved.