PHOENIX (AP) — Gov. Jan Brewer is revealing details of her proposal to expand Medicaid to about 300,000 low-income Arizonans, planning a Tuesday afternoon event with supporters of her plan to outline the bill she hopes lawmakers pass to implement the expansion.
Brewer has revealed few details of how she expects her proposal to be implemented since she surprised many nearly two months ago by announcing she backed an expansion. That announcement came after years of staunch opposition to President Barack Obama's health care overhaul law that saw Arizona join with other states in an unsuccessful effort to get the U.S. Supreme Court to overturn the Affordable Care Act.
Brewer is relying on a new hospital bed tax to pay the state's share of the cost to provide insurance to Arizonans making up to 138 percent of the federal poverty level, but there's opposition from some hospitals that see few uninsured patients to participate in what she's calling an "assessment."
She plans to release draft legislation that will outline how the plan will work. It could also contain sweeteners designed to get support from some fellow Republicans who oppose the concept.
Brewer faces strong opposition from many fellow Republicans who don't support the Affordable Care Act. Senate President Andy Biggs said there's virtually no chance he'll vote for it, and House Speaker Andy Tobin has said he believes enabling legislation should include lawsuit reform and audits of the state plan and of hospitals paying any new assessment. He and others also believe the assessment triggers a 2/3 vote requirement for new taxes. Brewer disagrees.
Others, however, think the state needs to embrace the expansion to provide care for poor Arizonans.
Rep. Heather Carter, R-Cave Creek, who heads the House health committee, calls the expansion a historic opportunity. She said last month that supporters need to make sure Arizonans understand the consequences of refusing the expansion. The end result, she said, could be the federal government pulling all funding for some parts of Medicaid if the program doesn't go ahead with the expansion, and hospitals could continue to see higher amounts of uncompensated care that Brewer contends drive up insurance costs for everyone.
That's been a key theme of Brewer's efforts to sell the proposal in the past two months. She has held press conferences around the state with business leaders and hospital officials, touting the financial benefits of getting more people insured. And she has rallied doctors at the Capitol, just last week bringing more than a hundred health care workers to an event next to the House of Representatives.
Brewer said the state can expect $1.6 billion in new federal funding a year by assessing hospitals about $250 million a year to pay for the state's share. She has promised to include a "circuit breaker" in enabling legislation that would pull Arizona out of the program if federal funding falls below 80 percent.
Under the federal legislation, Washington would pay the entire cost of the Medicaid expansion for the first three years, gradually phasing down to 90 percent of the cost after that. It's a far more generous matching rate than the federal government provides for other parts of the Medicaid program.