Senate Medicaid battle leaves GOP majority split

By By BOB CHRISTIE

PHOENIX (AP) — An Arizona Senate battle over expanding Medicaid revealed a fractured Republican majority that is likely to be exposed next in the House of Representatives as it takes up Gov. Jan Brewer's top priority.

Thursday's daylong Senate fight between conservative Republican senators and five GOP moderates who joined Democrats to vote to adopt a signature part of President Barack Obama's health care overhaul left behind an angry group of opponents who felt betrayed.

The $8.8 billion state spending plan that includes Medicaid expansion now moves to the House, where Republican Speaker Andy Tobin faces a similar dynamic, with moderates in his party likely to join 24 Democrats who openly support Brewer's plan. That's more than enough votes to pass the expansion.

But unlike Senate President Andy Biggs — who refused to even consider expanding the state's Medicaid plan to include the estimated 300,000 people making between 100 percent and 138 percent of the federal poverty line — Tobin has a competing proposal to cover them.

Tobin's proposal envisions sending the plan to the ballot, getting voters to approve the hospital assessment Brewer wants to cover the state's costs, and tightening an escape clause she wants that would cancel the expansion if the federal government failed to provide the promised money. It also includes other items Tobin wants, including assurances that hospitals don't pass on the assessment to insurers. Brewer has steadfastly rejected a ballot referral.

Some House Republicans concede Tobin's plan has no chance, and say the battle could play out like what happened Thursday in the Senate.

Tobin could propose his own budget, and he's said he wants it to be balanced and not rely on money left over from this budget year. Or he could adopt the Senate budget, run it through the Appropriations Committee and set it up for a floor fight next week.

But Tobin said Friday he doesn't plan to hurry the budget through.

"I have no intention of rushing through anything," he said. "I have an intention of well-negotiating and presenting a budget that gets the support of the Legislature and the executive."

Biggs revealed his budget proposal Tuesday and it passed Thursday, after Majority Leader John McComish joined with other moderates and all 13 Democrats in tacking on the Medicaid provision.

That was a risky move for McComish, one that could put his GOP leadership position at risk. Conservative members of the Senate GOP caucus were clearly angry Thursday.

"I think that it is a betrayal of this caucus," Sen. Rick Murphy said during a meeting of Republicans before the floor session.

They could oust McComish from his post, along with Majority Whip Adam Driggs, because they supported Medicaid. McComish said Friday he knows that could happen.

"Of course it would bother me very much," he said. "It would not cause me any regret for the decision that I made. The decision that I made I think was in the best interests of the people of the state of Arizona, and if there are consequences to that then I'll have to suffer them."

Brewer cheered Thursday's Senate vote, but all but ignored the bitterness that was displayed by the losing conservatives while acknowledging a tough fight ahead.

"I thank the Arizona State Senate for acting in bipartisan, courageous and collegial fashion today to approve the single most critical policy issue that has faced our State in years: the restoration of our Medicaid program in accordance with the wishes of Arizona voters," she said in a statement after the Thursday night vote.

"Now, I look forward to a similarly lively and productive debate in the Arizona House of Representatives."

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