Fat tax: Arizona's Medicaid program looks at charging smokers, diabetics, obese $50 a year (USA)

Arizona's cash-strapped Medicaid program is considering charging patients $50 a year if they smoke, have diabetes or are overweight. A spokeswoman for the Arizona Health Care Cost Containment System said that the fee is intended to rein in health care costs by pushing patients to keep themselves healthy. "It engages the consumer to start having a greater awareness of how they fit into the bigger health care puzzle," said Monica Coury, spokeswoman for AHCCCS. "We want to be able to provide health care to people. And we want to stretch our dollars as far as we can. Part of that is engaging people to take better care of themselves." Some private employers and state governments have instituted higher insurance premiums for workers who are overweight or smoke, but Arizona's plan would mark the first time a state-federal health care program for low-income residents has charged people for unhealthy lifestyles. The fee would apply only to certain childless adults. One part of the proposal affects people with diabetes. Coury says diabetics who fail to follow their doctor's orders to lose weight would be subjected to the $50 charge. Democratic state Sen. Kyrsten Sinema said that isn't fair to diabetics