Arizona Senate to vote on budget, Medicaid growth

PHOENIX (AP) — The Arizona Senate is poised to pass an $8.8 billion state budget Thursday that includes the Medicaid expansion sought by Republican Gov. Jan Brewer as she embraces a signature part of President Barack Obama’s health care overhaul law over the opposition of most GOP legislators.

The Arizona House passed the proposals early Thursday after working through the night, putting Brewer one vote away from a huge political victory that will expand health care to 300,000 more low-income Arizonans. Conservatives proposed more than 50 amendments and debated for more than 12 hours in an attempt to block the inevitable, but they didn’t have the votes to stop the Medicaid expansion or the budget deal.

If all goes as planned, the Legislature is expected to adjourn the 2013 legislative session by late Thursday.

A newly formed coalition of Democrats and GOP moderates forced the budget and Medicaid expansion proposal to move through the Arizona Senate and House as conservative Republicans railed against the Medicaid plan and accused members of their party who supported Brewer of being turncoats. The expansion is optional under last year’s Supreme Court decision upholding the law, and many Republican governors rejected it.

Brewer was one of the most vocal governors opposing the Affordable Care Act but acknowledged in January that it was the law of the land and would help Arizonans get care, lower the amount of uncompensated care hospitals must absorb and help cut what she called a hidden health care tax people who buy insurance pay in higher premiums to cover others’ uncompensated care.

Her proposal was met with derision from conservatives and Republican leaders in the Legislature who argued that it was a massive expansion of government, would drive the federal government deeper into debt and that the government promises of paying for the expansion would turn out to be false.

Opponents led by the Senate president and House speaker blocked actions for months, with the Senate finally adopting it in May. Speaker Andy Tobin continued to stall as he tried to get Brewer to compromise, and she finally had enough Tuesday and called the Legislature into special session. Both chambers started afresh Tuesday evening.

Brewer’s allies refused to so much as answer questions on the floor or debate provisions in the proposed budget this week. Instead, lawmakers exchanged barbs and policy rebuttals on Twitter long into the night.

“How are you not embarrassed for yourself?” asked Republican Rep. J. D. Mesnard, of Chandler, an opponent of the expansion, as the House began debate. “Is anyone going to stand up and give a defense?”

Many Republicans blamed Brewer for the discord.

“I’ve never see this,” said Republican Rep. Eddie Farnsworth, of Gilbert. “I’ve never seen the case where a governor has rolled over her own party because she was throwing a temper tantrum.”

Rep. Bob Robson, R-Chandler, said Brewer’s supporters had no choice but to act because state agencies need funding in place before the budget year starts July 1.

Republicans control the Legislature and all statewide elected offices in Arizona, but the Medicaid fight has highlighted internal fractures between those who want smaller government and others who, like Brewer, say broader health care access is good for the state.

Senate President Andy Biggs, who fought the Medicaid expansion throughout the regular session that began in January, implored Democrats and moderate Republicans to allow for debate after he was sidelined by Brewer’s supporters.

“Some don’t want to have discussion and think I am trying to embarrass them. I am not trying to embarrass them. This is a massive bill,” he said on the floor.

As Republicans grew increasingly irate, Brewer’s office released a statement striving to distance her from the federal health care law that allows for the Medicaid expansion.

“Arizona’s Medicaid program, known as AHCCCS, has existed for three decades … going back to President Obama’s college days,” wrote spokesman Matthew Benson in an email. “AHCCCS is not the Affordable Care Act. It is not Obamacare. It is the nation’s gold standard in terms of cost-effective Medicaid programs.”

The Medicaid plan would cover people making between 100 percent and 138 percent of the federal poverty level and restore coverage to more than 100,000 childless adults who lost Medicaid coverage because of a state budget crunch. About 1.3 million Arizonans already are covered by the state’s plan.

Biggs and Tobin have said the federal government is likely to go back on its promise to fund the Medicaid expansion and point to the huge federal debt.

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