Court Okays Republican Challenge To Arizona Medicaid Expansion

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Arizona’s Supreme Court ruled Wednesday that a lawsuit brought by state Republicans against Gov. Jan Brewer’s Medicaid expansion can proceed.

Thirty-six Republican state lawmakers are suing outgoing Republican Gov. Brewer over the legality of a hospital assessment which will fund Brewer’s plan to expand Medicaid. Brewer’s plan would tax Arizona hospitals to pay for an additional 300,000 Arizonans to join Medicaid as part of Obamacare’s expansion of the program. The state needs the tax to come up with matching funds to pay for its share of the Medicaid expansion.

State Republicans are suing Brewer because they argue hospital assessment is a tax that requires approval by a two-thirds majority of the state legislature, a hurdle which the plan failed to beat. Just a slight majority of the legislature voted for the expansion.

“Regardless of how the case ultimately comes out, today’s decision means that lawmakers can’t vote to ignore the Constitution,” said Christina Sandefur, an attorney at the conservative Goldwater Institute who argued the case.

Brewer told the Associated Press in November that if the lawsuit were allowed to proceed, it “could be fatal, it could be a catastrophe.”

“Let’s be perfectly clear: Preventing Medicaid restoration would threaten our safety-net hospitals and decimate our state budget, including funding for our [Department of Child Safety] and education and public safety,” Brewer told the AP in November.

But in response to the court’s decision Wednesday, Brewer held that the “battle is not over.”

“While I am naturally disappointed in today’s ruling by the Arizona Supreme Court, it simply means that the state now has the opportunity to fully defend the merits of our Medicaid restoration law in superior court,” Brewer said. “I am abundantly confident that Arizona will ultimately prevail.”

The Arizona governor is limited to two terms and Brewer is already on her way out of office. But the ongoing challenge to the Republican-controlled state’s Medicaid expansion could be a blow to other red states that are considering accepting Obamacare’s expansion as well.

Four years after the Affordable Care Act passed, just 27 states and Washington, D.C. have decided to expand Medicaid. Several other states are in discussions with the federal government about how to implement an expansion in their own states.

Some Republicans, like Indiana Gov. Mike Pence, are trying to insert some conservative ideas into the Medicaid expansion. Pence spent much of 2014 trying to get federal approval for an Indiana Medicaid expansion, but has gotten stuck over charging a small contribution to expansion customers.

The pushback for expansion in Republican-controlled states can be severe, however. If the challenge to Brewer’s plan is ultimately successful, other states may be dissuaded from attempting to expand Medicaid after all.

It will be up to Republican governor-elect Doug Ducey, who takes office in January, to defend the administration against the lawmakers’ lawsuit. Ducey vocally opposed Brewer’s plan during his election last November, but said that shutting the expansion down after thousands of Arizonans have already been put on the Medicaid rolls was unrealistic.

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