Arizona’s cash-strapped Medicaid program is considering charging patients $50 a year if they smoke, have diabetes or are overweight, reports The Associated Press.

According to the spokeswoman for the Arizona Health Care Cost Containment System Friday, the fee, which will only apply to childless adults, is intended to cut health care costs by pushing patients to be 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.”

This would mark the first time a state-federal health care program for low-income residents will charge people for unhealthy lifestyles.

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