Arizona Eagletarian

Arizona Eagletarian

Sunday, April 14, 2013

Medicaid Expansion in Arizona

Other than the lingering question of whether legislative district lines will be modified for the 2014 election cycle, enactment of Medicaid expansion under Obamacare is among the top public policy issues yet to be decided in the Arizona Legislature this year.

However, as a practical matter, the issue HAS already been decided whether journalists, pundits and activists of various flavors are ready to accept the fact yet or not.

Phoenix Business Journal's Mike Sunnucks writes:
While it appears conservative opposition to Brewer’s full-court press may not be enough to stop the expansion, anti-abortion advocates want to include language in the Medicaid bill specifically restricting funds from being used for abortions and for any AHCCCS money to be allocated to Planned Parenthood. Planned Parenthood is backing the Medicaid expansion.
Sunnucks also wrote:
While some business groups are aggressively in governor’s camp, others talk about political realities.
“Regardless of if we expand Medicaid in Arizona or not, the federal government will spend the money and Arizonans we will have to pay for it. We are trying to make the best out of a bad situation,” said Arizona Small Business Association CEO Rick Murray in a blog post on his group’s website. 
I have to wonder if Sunnucks' apparent hedging wasn't just being "politically correct" according to his employer's editorial requirements. Murray's statement sounds to me like he knows we need the expansion in our state whether vocal (i.e. obnoxiously hostile) conservatives are ready to accept it or not.

What do those hostile conservatives have up their sleeves? Recently, copies of a mailer targeting Gov. Brewer's legislative point person, state Rep. Heather Carter (R-Cave Creek) on Medicaid expansion were apparently left on the desks (on the House floor) of members.

The mailer was apparently paid for by one of the Koch Brothers' favorite "charities," Americans for Prosperity. The local chapter of which is headed up by Tom Jenney.

This morning, on Channel 12's Sunday Square Off, local broadcast reporter Brahm Resnik spoke with Gov. Brewer's chief political adviser Chuck Coughlin about the issue. Coughlin said "the legislature's own economist, Marshall Vest, said, 'adopting this program will be the most significant enhancement to the state's economy in the short term.'" Naturally, Coughlin demurred rather than sound overconfident about the adoption of the expansion.

However, even though Coughlin, Brewer and others have discussed (see video clip below) that Arizonans have twice voted to extend Medicaid (AHCCCS) coverage beyond what state officials previously wanted, the bottom line -- from Brewer's point of view -- is the very easily foreseeable impact on Arizona's overall economy by bringing in billions of additional federal dollars. Conversely, the adverse impact, especially on rural Arizona health care infrastructure, to refusing the federal funding is likely catastrophe.
In the meantime, a coalition of business leaders began running television advertisements promoting Ms. Brewer’s plan as a lifeline to hospitals, particularly in rural areas, where the number of Medicaid recipients is large, as is the number of uninsured seeking care in emergency rooms.
So, why do I think the fight is all but finished?

For one thing, chief GOP bully Cathi Herrod's letter to Brewer and legislative leaders concedes the point with the only caveat that Herrod wants assurance that expansion will not enable any government money to be used to fund abortions.

Second, House Speaker Andy Tobin issued a memo to all Members of the House subsequent to distribution of the Carter hit piece.
This is a reminder that the custom and practice of the House regarding the distribution of papers to members’ desks on the Floor has been that, except for routine business from the Chief Clerk, any distribution must have the prior approval of the Speaker’s Office. Additionally, it is always inappropriate to enter and leave materials in members’ offices without their permission. Just like impugning a member on the Floor is prohibited, the distribution of materials to members’ offices of a derogatory nature towards House members is also prohibited.
One might expect the People's Representatives to have a sense of dignity and decency by the time they get elected from any legislative district. We have come to understand that when it comes to Tea Party affiliations especially, that's not necessarily the case in Arizona. Hence Tobin having to put his foot down to ensure he maintains order in the House.

While I could go on and on, my last point will be that Brewer has held press conferences on the Capitol lawn on more than one occasion already. She has made it abundantly clear that this issue is one of two top priorities she has for this legislative session. Despite all of her foibles and shortcomings,

Further, Brewer's adviser Coughlin was behind development of this YouTube video explaining the governor's position.

And then there is the recent saga of former Arizona Department of Veterans' Services director Joey Strickland.

Brewer's chief of staff, Scott Smith demanded Strickland's resignation apparently because the former Army Lt. Colonel had offered former state Rep. Terri Proud a job as an administrative assistant.

Proud was an outspoken Tea Party affiliated Republican. She was also clearly a RWNJ. And that is about the kindest thing I can say about her. Bottom line is that she was and apparently still is "radioactive," politically speaking. Brewer took a lot of flak from veterans' groups about Strickland being forced out. But she did not even blink. There was not the slightest indication of wavering on her part.

In comments on local news websites regarding the issue, I speculated -- and still believe very emphatically -- that the entire situation with Proud was a "shot across the bow" to lawmakers who dare to oppose her on this issue.

Jan Brewer holds all the cards. She has veto power over legislation and she's not afraid to use it. She has not yet had to resort to it. Tea Party affiliated GOP lawmakers who dare to go toe-to-toe with her on her top policy issues will suffer political consequences that could make Tom Jenney's threats (see the mailer above) look like junior high school pranks.

Brewer is nothing if not clever and determined.

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