Arizona Medicaid Expansion in Doubt After State Supreme Court Ruling

The future of Arizona's Medicaid expansion was thrown in doubt on Wednesday after the state Supreme Court ruled that a legal challenge to the program could move ahead.

Thirty-six Arizona lawmakers who voted against the Medicaid bill in 2013 were injured as a group, the court ruled in an opinion released today, by a companion piece of legislation that allowed the bill to pass with a simple majority. The opposing lawmakers argue in their lawsuit that the Medicaid bill is a tax that requires a supermajority vote by the Legislature.

The law requires hospitals to help fund government health insurance for about 300,000 Arizonans, and Governor Jan Brewer, who previously told the press that if the lawsuit was allowed to proceed, it "could be fatal, it could be a catastrophe."

See also: -Jan Brewer's Medicaid Expansion Plan Passes Legislature

Brewer summoned nearly all of her political strength to muscle the bill past conservative, anti-Obamacare legislators last year. She announced she'd veto any bill that came before her other than the Medicaid bill, and called an unprecedented evening legislative session against the wishes of her own party after stalling tactics by GOP House Speaker Andy Tobin. The Arizona-based Goldwater Institute, which is providing attorneys for the lawsuit, claims Brewer "embraced underhanded and even unconstitutional tactics" to ram the bill into law.

Key lawmakers met with Brewer and "agreed to unseat the speaker and Senate president, if necessary, to get Medicaid expansion and the budget passed," according to an Arizona Republic article at the time.

Brewer said the law meant Arizona would reap about $8 billion in federal funds over the next four years.

Opponents point out that, whatever the supposed benefit, a successful 1992 citizens initiative, Proposition 108, requires a 2/3 legislative vote for all tax hikes. That became the first issue before the court system when lawmakers sued in September of 2013, arguing that the "provider tax" required of hospitals ignores the voter-approved law. The lawsuit alleges violations of Proposition 108 and the Arizona Constitution's separation-of-powers clauses.

The state Court of Appeals reversed a ruling by Maricopa County Superior Court Judge Katherine Cooper that the legislators lacked standing. Brewer appealed to the higher court, which has now ruled against her.

The ruling doesn't address the merits of the case -- that is, whether the 2013 expansion vote actually required a two-thirds majority to pass. But that'll now be determined by the Superior Court following the 5-0 ruling by the Supreme Court.

Brewer's office issued the following statement in response to the ruling:

"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. I am abundantly confident that Arizona will ultimately prevail, and that the state will be able to focus on implementing one of the most meaningful and critical health care policies in years - the restoration of crucial, cost-effective care to thousands of Arizonans.

"Still, today's ruling carries with it troubling consequences for future leaders by enabling our courts to referee legislative battles, and possibly opening a Pandora's Box for additional baseless, politically-charged lawsuits.

"So this battle is not over. I stand with the great majority of Arizonans in defending this necessary and crucial policy, safeguarding our rural and safety-net hospitals and protecting our state budget.

"Medicaid restoration is the right choice for Arizona ... it's worth fighting for ... and I'm proud to have done that as governor. I am confident the fight will continue, and that the law will ultimately be upheld."

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Ray Stern has worked as a newspaper reporter in Arizona for more than two decades. He's won numerous awards for his reporting, including the Arizona Press Club's Don Bolles Award for Investigative Journalism.