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4/27/2013 10:00:00 PM
Medicaid expansion debate hits home
Joanna Dodder Nellans
The Daily Courier

As a Medicaid showdown between the Arizona Legislature and Gov. Jan Brewer continues, groups within Yavapai County are taking sides in public.

Sen. Steve Pierce of rural Prescott has been one of the most vocal supporters of Brewer's proposal to expand Medicaid to about 300,000 poor Arizonans.

But neither of the legislative chambers has scheduled votes on her proposal, and therefore the state's annual budget also is stalled. The governor has attended numerous rallies in support of her plan, while Senate President Andy Biggs and others have organized a rallies against it.

"It'll get passed," Pierce told the Associated Press. "She's got the power of the veto and she will be there until she gets it."

House Speaker Andy Tobin of Paulden said he doesn't think he has the votes to get the Medicaid plan approved in his chamber, and he'd like amendments such as tort reform.

Pierce told The Daily Courier he's unhappy that the 10 area directors of the Yavapai County Republican Party approved a resolution against the governor's plan and asked the Legislature to do the same.

And the Yavapai Regional Medical Center Board of Directors sent a letter to the Republican area directors saying their resolution "fails to recognize the realities faced by your local healthcare providers."

The YRMC letter noted that its hospital was listed by Moody's this month as the 12th most vulnerable hospital in the country to a new 2 percent cut in federal Medicare reimbursements under sequestration. That's because 58 percent of YRMC gross revenues come from Medicare, or nearly twice the state and national average.

The sequestration cut more than $2 million annually from YRMC revenues, the letter said.

"We must work within the current design of the Affordable Care Act if we expect to survive," the YRMC letter said.

Yavapai County Supervisor Chip Davis also sent out a press release arguing that the governor's plan would be a huge benefit to the county's budget, since the county's costs to provide mandated mental healthcare services with property taxes have more than doubled to $1.8 million in one year.

All five supervisors voted to support the governor's plan, citing economic benefits as well. The Prescott and Prescott Valley chambers also have registered support for the plan.

"While I am unaware of any public discussion or polling of Republican membership regarding the resolution passed by our area directors, I will tell you that the Board of Supervisors had our discussion in public," Davis wrote.

Under the governor's plan, hospitals would pay the state's $250 million annual match to get $1.6 billion annually from the federal government to expand Medicare to people living at 138 percent of the poverty level. Hospitals couldn't pass their assessment costs onto paying customers.

The governor's plan also includes a "circuit breaker" to automatically end the state's participation in the expanded program if the federal government share drops below 80 percent.

The governor's plan gives the state's Medicaid chief too much power to raise and lower hospital assessments, Tobin said.

The county party area directors' resolution predicts "the taxpaying citizens of Arizona will be forced to assume the financial burden of maintaining this massive expansion when the federal funds fail."

The resolution says the area directors have a "better understanding of the concerns of the voter base," but doesn't name whom they are comparing their understanding to.

"The area directors do not represent the Republican Party as a whole," Pierce said. "This is a group that disagrees. The governor has polling that the majority of folks statewide want it."

Mal Barrett, Jr., immediate past chair of the county Republican Party who now is a precinct committee person, also criticized the resolution process.

"Area directors did not ask for any precinct committeemen opinions before they did this," Barrett said. "Most of the PCs don't even know who their area directors are." The county Republican Party has 10 area directors and more than 200 PCs, he said, and each PC votes on one area director for his or her geographical area.

Area directors' names do not appear to be listed online, and the county Republican Chair Jim Dutton did not return a call seeking their names and sources for some of the resolution's claims.

The county party has a resolutions committee to present resolutions to PCs for voting.

The county Republican Party bylaws say the area directors serve at the pleasure of the county chair and their duties are "to organize the area for effective and continuous organizational works on behalf of the Republican Party and its candidates."



Reader Comments

Posted: Sunday, April 28, 2013
Article comment by: lol at yall

HA, you talking about the same Brewer that said she would not take a single dollar of Obama care money because it was unconstitutional? Same Brewer who let liver transplant patients die with cuts to the AZ medical programs? Yup.. She cares... She cares about all the beheadings she has seen along the borders! :)

Posted: Sunday, April 28, 2013
Article comment by: Sounds Like

It sounds like politics and Big Money as usual, and they don't care about the people who need and cannot afford decent medical care. Brewer sounds like she cares. There are so few doctors accepting new patients as it is, (and I am not able to see a REAL doctor because of it). I hope they don't make that situation worse. I was raised to believe that doctors cared for people first and foremost, that seems to have changed over the years.



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