PHOENIX - The Arizona Legislature embraced a signature component of President Barack Obama's healthcare law Thursday after a drawn out battle that divided the state's Republican leadership and saw GOP Gov. Jan Brewer work closely with Democratic lawmakers to expand Medicaid access.
The Legislature passed Brewer's $8.8 billion state budget and Medicaid expansion after months of stalled negotiations, tense debates and political maneuvering from both sides.
Brewer called it a "sweet victory" for Arizona's budget and its people. The expansion will provide health insurance to an additional 300,000 poor Arizonans under a key provision of the Affordable Care Act.
"The day has been a red-letter day for the people of Arizona," Brewer said. "It was a win, win, win all the way around."
A newly formed coalition of Democrats and moderate Republicans worked closely with Brewer to push back against the conservative leaders who run the Legislature and had blocked debate on the Medicaid expansion for six months. Lawmakers worked through the night Wednesday to get the plan through the House, and the Senate vote came hours later Thursday afternoon.
Brewer, an early critic of the Affordable Care Act, surprised the nation when she embraced the Medicaid expansion as the law of the land in her State of the State address in January. She noted that rejecting an expansion would mean Arizona taxpayers would subsidize care for those in other states while receiving no benefits themselves.
The expansion is expected to help reduce the amount of uncompensated care hospitals must absorb and help cut what Brewer called a hidden health care tax that people who buy insurance pay, through higher premiums, to cover others' care.
After the Legislature secured her political win, Brewer softened her support for the healthcare law Thursday.
"Medicaid was here long before Obama healthcare. I have never liked Obama healthcare," she told reporters after the vote. "It has nothing to do with Obama healthcare."
Republicans control the Legislature and all statewide elected offices in Arizona, but the Medicaid fight highlighted internal fractures between those who want smaller government and others who, like Brewer, say broader healthcare access is good for the state.
The expansion is optional under last year's Supreme Court decision upholding the healthcare law, and many Republican governors rejected it.
In all, 23 states plus Washington, D.C., are moving ahead with the expansion, while 15 states have turned it down. Another 12 states are still weighing options. Nearly all the states refusing are led by Republicans.
Washington will pick up the entire cost of the expansion for the first three years and 90 percent over the longer haul. It's estimated that less than $100 billion in state spending could trigger nearly $1 trillion in federal dollars over a decade.
In Arizona, Republican leaders in the Legislature called the expansion a massive government overreach that would drive the federal government deeper into debt. They predicted the government promises of paying for the expansion would turn out to be false.
The Senate president and House speaker had blocked action on the expansion for months, with the Senate finally adopting it in May. Speaker Andy Tobin continued to stall as he tried to get Brewer to compromise, but she finally had enough Tuesday and called the Legislature into a surprise special session.