Robert M. La Follette School of Public Affairs
Monday, April 28, 2014

Kohler manages Arizona Medicaid expansion


Beth Kohler

No one knows better than 2000 alum Beth Kohler how busy the world of Medicaid is.

As the deputy director of Arizona's Medicaid program, Kohler oversees the day-to-day operations of the Arizona Health Care Cost Containment System. "I help set the strategic vision for the program," Kohler says. "This includes direct oversight of our business and finance, member services, information technology/services, rates and reimbursement, intergovernmental relations and business intelligence/data analytics functions."

Governor Janice Brewer proposed in 2013 to restore Medicaid coverage to roughly 250,000 Arizonans unable to enroll in AHCCCS due to an enrollment freeze. "Using enhanced federal funding made available by the Affordable Care Act, the governor proposed covering individuals up to 133 percent of the federal poverty level," Kohler says. "Although a voter-approved Arizona law has required, for more than a decade, coverage for all Arizonans up to 100 percent of the federal poverty level, the battle over the governor's proposal was still incredibly challenging."

Kohler and others in the governor's administration helped pull together a broad coalition of health care stakeholders, the business community and the public to convince the Legislature that the proposal should move forward, Kohler says.

"After we received legislative approval, we began the challenging task of implementing the coverage restoration," Kohler says. "Tasked with developing a hospital assessment to help fund the initiative, I was able to structure an assessment that met all federal parameters and resulted in every hospital system in the state being in a positive position. Finally, in the midst of this, we rolled out a new eligibility system and process. We have enrolled more than 100,000 individuals in coverage since January. I have been incredibly proud to be part of this effort."

After graduating from the La Follette School with a Master of Public Affairs degree, Kohler moved to Arizona and became a senior fiscal analyst with the Legislature's joint budget committee. After four years, she became an assistant director of research with the Arizona Senate, then spent a couple of years in the private sector as a managing consultant.

Kohler returned to state government when Brewer was elected in 2009, serving as her deputy policy director. She became deputy director of the Medicaid program in 2011.

While at La Follette, Kohler was a project assistant for Barbara Wolfe at the Institute for Research on Poverty. "At the time, states were standing up their Children's Health Insurance Programs, and I helped analyze their progress and the various structures of the programs," Kohler says. "It gave me a good understanding of the vast differences in state approaches to health coverage for low-income populations and the challenges they face in implementation."

"When I started La Follette, I anticipated working for the federal government or a national think tank," Kohler says. "Never did I think I'd work in state government. Fourteen years later, I have spent most of my career in state service. La Follette gave me a good perspective on some of the opportunities state government offers, and how states are often innovation laboratories and where much of the 'real work' gets done."