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The Arizona's cash-strapped Medicaid program is considering charging patients $50 a year if they smoke, have diabetes or are overweight. The fee is intended to act as guiding power in health care costs by enabling patients to stay healthy according to a spokes woman for the Arizona Health Care Cost Containment.

"Unlike the state government and some employers, who have charged higher premiums for workers who are overweight or smoke, this plan would mark the first time people are charged for unhealthy lifestyles by a state - federal health care program for low income residents. The fee is to be applied only by specific adults with no children thus one part of the proposal affects people with diabetes.

According to Democratic state Sen. Kyrsten Sinema the proposal is not fair for the diabetics. Obese people are chronically ill, smokers are required to work with a primary-care physician in order to help them lose weight and improve their health. Those patients who don't meet the specified goals under the proposal will be required to pay $50.

Although the plan requires approval by the Republican-controlled Legislature, the legislature has been considering a cut of $500 million to Arizona's Medicaid program to help eliminate a state budget deficit of nearly $1.5 billion. Hence a fee for medical patients would also need federal authorization, which would prevent Arizona from enforcing the fee due to existing federal rules. Coury says the fee is a way of showing the federal government Arizona is serious about getting people healthy while stretching and managing dollars better.

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