Is Arizona on the right track? While the “fat fee” in Gov. Janet Brewer's Medicaid proposal would financially punish patients of the provider for unhealthy habits, it could fill in roughly $500 million of the state's current $1.1 billion budget gap. Obese patients would only be charged if they did not follow Medicaid's plan for dropping pounds. Similarly, smokers would be fined for refusing to quit. The proposal includes plans that would freeze enrollment of certain classes and cut others, both of which got a lot of heat from the press when they were first introduced last year. Arizona is not the only state to propose a health-care fee aimed at obesity: In 2008, Alabama required obese government employees whose insurance was free to pay $25 a month if they did not attempt to lose weight.