The state tried to have a copay for Medicaid before, in the late 80's I think. It was before I worked at the health department, but I heard about it. It was ended by the clients themselves. They just refused to pay and demanded services anyway. The State caved.
Back when our home health patients were requested to pay a $2 co-pay if they had it. I don't call that "refusing to pay" or "demanding service". You really have a deep-seated hatred of the poor, don't you?
Now I can see why you no longer work at the Health Dept.