Arizona House holds 1st Medicaid expansion hearing

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By Jennifer Thomas By Jennifer Thomas

PHOENIX (AP) -- Arizona Gov. Jan Brewer's push to expand the state's Medicaid plan was alternately heaped with praise and derided as unaffordable government overreach at its first legislative hearing Wednesday, and the head of her own Republican Party in Maricopa County compared her to Judas.

The "informational" hearing came more than two months after Brewer surprised many by changing course and announcing she was embracing a key part of President Barack Obama's federal health care overhaul law after years of opposition.

The hours-long House Appropriations Committee meeting included heartfelt pleas from patients asking lawmakers to back the increase and a spirited debate between Republicans and Democrats. The hearing ended Wednesday night.

The hearing highlighted the rough road Brewer's plan faces, with conservative Republicans strongly opposed, including many top GOP leaders.

A.J. LaFaro, chairman of Maricopa County Republicans, blasted the plan and said the vast majority of Republicans in the state opposed the expansion. He recounted how Brewer and her advisers called GOP committee and precinct leaders to a briefing after her January announcement, but they walked away unpersuaded.

"If we rejected Obamacare, why would we support Medicaid expansion?" he told the committee. "Let me assure you, overwhelmingly, the Republicans in this state are against this proposal."

He ended his testimony by comparing her to a disciple who sold out Jesus Christ.

"Jesus had Judas, Republicans had governor Brewer," he said as gasps were heard in the packed hearing room.

Most of Wednesday's testimony was less tense, and included many supporters, including health care professionals, a former head of AHCCCS and Glenn Hamer, president of the Arizona Chamber of Commerce and Industry.

The governor's plan calls for an assessment on hospitals to bring in about $250 million a year to pay for the state's share of an expanded Medicaid program. The state can expect $1.6 billion a year in new federal funding, freeing health care providers of hundreds of millions of dollars in uncompensated care.

"This is a math issue for the state of Arizona," Hamer said. "This is an Arizona program and we believe that through the governor's plan, we are going to more effectively provide care to Arizona people."

Rep. John Kavanagh and other Republicans peppered Hamer with questions, with some committee member using his testimony as an entry into a philosophical debate on the role of state and federal government responsibilities and the federal deficit and debt.

The hearing, however, was only political theater at this point, because no bill has been filed in the Legislature to implement the plan Brewer hopes will add at least 300,000 poor Arizonans to the nearly 1.3 million now covered by the state's version of Medicaid.

Brewer is leaning on the Legislature to act, telling leaders to ease up on sending legislation to her desk to sign until she sees movement on her priorities, which besides Medicaid include an overhaul of the state's complex sales tax collection system.

Kavanagh, one of the strongest Medicaid expansion opponents in the House, chairs the Appropriations Committee that held the hearing Wednesday.

Brewer rolled out draft legislation last week after two months of a charm offensive where she used her office's bully pulpit to gather supporters, including many in the health care field, patients and the business community. But it wasn't assigned a bill number by House Speaker Andy Tobin, or sent to the Health Committee for consideration, where Rep. Heather Carter, R-Cave Creek, is a supporter.

Tobin himself says he won't bring the bill to a floor vote unless he has a majority of his caucus on board. Republicans hold 36 seats in the House, while Democrats who back the measure hold 24. He also is philosophically opposed to the expansion but hasn't come out in blunt opposition. Instead, he's looking for lawsuit reform, audits of the state plan and of hospitals paying a new assessment that Brewer wants to help pay the state's share to ensure those costs aren't passed on to insurers.

"The issue is can you pass what the governor has proposed, and that answer is no," he told The Associated Press on Tuesday. "So you have to find something else that is passable and I don't know if that is possible."

Still, there are Republican supporters, including Carter, Rep. Kate Brophy McGee and Sen. Steve Pierce.

Brewer also is backed by many in the powerful business community and health care officials, and she has the ability to veto bills sent to her by the Legislature if she doesn't get her way. That's a powerful tool she's used before.