PHOENIX (AP) — The Arizona House passed an $8.8 billion state budget that includes Medicaid expansion early Thursday and puts Gov. Jan Brewer one Senate vote away from a huge political victory as she embraces a signature part of the Patient Protection and Affordable Care Act (PPACA).
A newly formed coalition of Democrats and GOP moderates forced the budget and Medicaid expansion proposal to move in the Arizona Senate and House during a day filled with debate. The Senate took a break after giving its initial approval Wednesday afternoon, while the House toiled into the night as conservative Republicans railed against the Medicaid proposal and accused members of their party who supported Brewer of being turncoats before taking a final vote that ended after 1:30 a.m. PDT.
The Senate is set to take up the budget and Brewer’s contentious Medicaid proposal for its final vote sometime after 9 a.m. Thursday. Votes last month and Wednesday show it has more than enough votes to pass and a budget could be on Brewer’s desk by the afternoon.
The action means Brewer, a Republican, is close to securing a huge victory that will provide health insurance to an additional 300,000 poor Arizonans by embracing a key part of the Affordable Care Act. The expansion is optional under last year’s Supreme Court decision upholding the law, and many Republican governors rejected it.
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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.
But 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. But Speaker Andy Tobin stalled 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.
During the floor debate Wednesday, Brewer’s allies largely refused to answer questions or discuss provisions in the proposed budget, drawing rebukes from conservatives who warned of unchecked government. They proposed more than 50 amendments but got none of them adopted and didn’t have the votes to stop the Medicaid expansion or the budget deal. Brewer’s allies refused to so much as answer questions on the floor or debate provisions in the proposed budget. Instead, lawmakers exchanged barbs and policy rebuttals on Twitter, the social networking site, 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?”
Republican Rep. Debbie Lesko of Peoria said the special session was unnecessary.
“I feel like I have been punched in the gut,” she said.
Republicans control the state 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.