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Brewer's Medicaid-expansion plan good for Ariz.

March 13, 2013
The Republic | azcentral.com
Editorial board

Gov. Jan Brewer officially put her plan on the table on Tuesday.

It is a straightforward — and forward-thinking — approach to expanding Medicaid.

Her toughest opponents are her fellow Republicans in the Legislature, and that’s too bad because this is a fiscally sensible plan.

Brewer is looking out for Arizona’s best interests. She wants to restore coverage to those who lost it during the Great Recession and expand coverage to bring in a generous federal match under the Affordable Care Act, aka “Obamacare.”

Her plan would bring in $1.6 billion in federal funding in fiscal 2015 alone. It would bring 300,000 people under medical coverage.

The humanitarian argument is compelling. It is simple decency to make sure sick people get the care they need. Arizona voters have supported this idea twice at the ballot box.

It also makes economic sense.

Keeping people off the Arizona Health Care Cost Containment System doesn’t prevent them from becoming sick. But it can mean they wind up in the emergency room — a less efficient way to deliver medical care that saddles hospitals with uncompensated costs.

That’s why hospitals enthusiastically support Brewer’s plan for a provider assessment — yes, some will call it a tax — to raise Arizona’s share of the cost and bring in the generous federal match. The governor’s plan bans hospitals from passing on the cost to patients.

In addition to health-care providers, the governor has the support of the Arizona Chamber of Commerce and other business leaders, religious groups and advocates for children, minorities and the elderly — 110 organizations in all. No wonder.

AHCCCS is an efficient, state-run program, not some federal behemoth. It was designed in Arizona for Arizonans. It is no shame to bring in federal dollars to help it serve more Arizonans.

Yes, we know there’s no such thing as free money, and it is absolutely correct that the federal match comes, in part, from taxes collected from Arizonans. But lawmakers should bring as much as they can back to the state.

It is Arizonans who will suffer, not Uncle Sam, if our hospitals stagger under the weight of uncompensated care.

Those who fear the federal government will fail to live up to the promise to pay the lion’s share of costs for expanding Medicaid also make a good point. But Brewer’s expansion includes a fail-safe. If federal support falls below 80percent, Arizona can walk away.

Fiscal conservatives in the Legislature need to swallow hard and go along with Brewer on this one. She’s not a wild-eyed liberal. She’s honed her conservative credentials over decades in public service. Brewer fought Obamacare with enormous vigor.

But that fight is over. Now the challenge is to make the program work for Arizona.

That’s exactly what the governor is trying to do.

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