The health care overhaul law signed by President Obama in March forbids Medicaid eligibility cuts by states. But Medicaid cuts can only be achieved one of three ways without major reform: 1) who gets Medicaid, 2) what they get from Medicaid, 3) how much Medicaid pays for those promised goods and services. So states have just two options left. They can cut what they offer or they can pay doctors less.

In Arizona, Medicaid has had “tremendous growth of people enrolled in the program,” according to the Arizona Republic. That growth is unsustainable given the state’s budget crisis.

To save $2.8 million a year starting in fiscal 2011-12, Arizona will no longer cover preventive services for its640,000 Medicaid recipients.