Jan Brewer (R), Arizona’s combative GOP governor, stunned political observers and health care reform advocates when she became the third Republican governor to endorse Obamacare’s expansion of the public Medicaid program. That decision is great news for Arizona’s poor and uninsured, as well as for the state’s budget. But it’s been met with fierce resistance from state lawmakers in Brewer’s own party, setting up an unusual showdown between Brewer, hospitals, doctors, and reform advocates on one side, and Republican state lawmakers — who Brewer must still persuade to pass legislation accepting the Medicaid expansion — on the other.
That’s why on Wednesday morning, flanked by Arizona public health officials on the steps of the state Capitol, Brewer begged reticent GOP lawmakers — many of whom showed up in black to protest Brewer’s decision — to look past politics and understand the human and financial toll that failing to pass the expansion would instill on Arizonanas. “The human cost of this tragedy can’t be calculated,” Brewer said. “Remember, there is no Plan B.” Brewer estimated that 50,000 low-income Arizonans would lose health coverage without the expansion.
Study after study has shown that expanding Medicaid is the right move for states’ budget, the poor, and the uninsured, especially considering that the federal government will fully finance states’ Medicaid expansions for the first three years. Republican governors, faced with the reality that Obamacare is here to stay, have finally been inching away from their knee-jerk opposition to the Medicaid expansion after intense lobbying from hospitals and advocacy groups.
But skeptics — particularly GOP lawmakers in Republican-led states open to the expansion — are wary of increasing their Medicaid pools, warning that the federal government may renege on its promise to provide the lion’s share of funding for the expansion. GOP governors will need these lawmakers’ support to actually expand Medicaid, and as Brewer’s example demonstrates, that could make for some intra-party conflict in the eight GOP-led states whose leaders have embraced the expansion.