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A year after Arizona approved Medicaid expansion, Brewer still fighting for it

Arizona Gov. Jan Brewer has forcefully defended President Barack Obama's Medicaid expansion. (Haraz N. Ghanbari/Associated Press)

Arizona Gov. Jan Brewer fought harder than any Republican governor last year to push through Obamacare's Medicaid expansion. Almost a year later, she's still fighting opposition to it on two fronts.

First, she vetoed a bill Tuesday that would have capped the Medicaid program. From the Associated Press:

A bill that would have forced able-bodied Medicaid recipients to get a job and would have limited some to a maximum of five years of insurance was vetoed Tuesday by Gov. Jan Brewer.

Brewer said in a veto letter that the five-year cap could have meant throwing more than 210,000 adults off the state's Medicaid program, and an additional 253,000 children as soon as they reached their 18th birthday.

Even if Brewer had signed the bill, it's unlikely the law would have taken effect in Arizona. It would have had to pass review by the Centers for Medicare and Medicaid Services, which had already warned that the Arizona bill ran counter to the goals of the Medicaid program.

Also on Tuesday, a state appellate court ruled that 36 Republican lawmakers who strongly opposed the Medicaid expansion have standing to challenge the legislative maneuver Brewer used to get the expansion approved. The lawmakers contend that the expansion legally required two-thirds legislative approval, as opposed to the simple majority it was passed on, because the expansion is funded by a tax on hospitals. Brewer, naturally, has vowed to fight this lawsuit.

Brewer appears to be the only Republican governor that is facing intra-party grief from state lawmakers in 2014 for approving the Medicaid expansion last year. Other Republican governors in Iowa, Michigan, Nevada, New Jersey, New Mexico, North Dakota and Ohio have all seen the battle over expansion essentially subside since then — for some of those governors, they didn't face much of a fight. And as Politico reported in February, some of the Republican governors are on pretty easy paths to re-election this year.

This is Brewer's last year as governor, so it'll be interesting to see how the nine candidates for the Republican nomination approach the Medicaid issue. Will any of them just as forcefully defend the Medicaid expansion?



Jason Millman covers all things health policy, with a focus on Obamacare implementation. He previously covered health policy for Politico.



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