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Senate gives preliminary approval to Medicaid expansion

A block of five Republican senators joined forces with Senate Democrats on May 16 to wrest control of the chamber from Sen. President Andy Biggs and provide momentum to Gov. Brewer’s proposal to expand Medicaid in Arizona.

Whether that wave of momentum carries over into the House next week, when representatives are likely to begin debating the $8.8 billion budget and the expansion of the Arizona Health Care Cost Containment system, remains unclear.

The votes for Brewer’s expansion plan in the House are far less certain than they were in the Senate.

Senate Majority Leader John McComish – backed by Republican Sens. Rich Crandall, R-Mesa, Adam Driggs, R-Phoenix, Steve Pierce, R-Prescott, and Bob Worsley, R-Mesa and help from Senate Democrats – effectively hijacked control from Biggs, R-Gilbert, to give preliminary approval to the expansion plan.

The coalition held an 18-12 majority on McComish’s Medicaid expansion amendment and provided sufficient votes to beat back measures sponsored by Biggs and Sen. Kelli Ward, R-Lake Havasu City, to weaken the proposal.

McComish, R-Phoenix, supported one of Biggs’ amendments: a sunset measure that would repeal Medicaid expansion on Jan. 1, 2017, essentially requiring the Legislature to vote again in four years and decide if the state still wants to continue the program.

“Those who oppose it are saying that in the out years, the money is going to go away, and we’re not going to be able to afford this, and I don’t think anybody knows that,” said McComish. He added that if the Senate supported Biggs’ alternative plan to provide health care for Arizonans with state funds, it would drain the rainy day fund, “and some amount more than that will also be affected.”

“The only thing we know for sure about the state of Arizona over the next three years is we’re going to lose money if we don’t pass Medicaid expansion. And with the Biggs floor amendment, we know that in three years, we get another crack at it,” he said.

House leaders will likely huddle next week to see what support there is in the chamber for the Senate budget and Medicaid expansion.

Sen. Katie Hobbs, D-Phoenix, said she hopes House Republicans will look to the Senate as a model for how to move the governor’s Medicaid proposal.

“I know that the Republicans are taking some heat – Sen. Kelli Ward was having a meltdown on Twitter – but this is what Arizonans are asking for. I don’t care if a majority of Republicans oppose it. A majority of Arizonans support it. It’s what we need to do,” Hobbs said.

Earlier in the day, Senate Republicans briefly entertained the possibility of blowing up the budget and starting from scratch next week, but budget deals reached by Senate Democrats and a few Republican dissenters forged ahead in approving the $8.8 billion budget – to the dismay of the majority of Republicans.

One by one, Democrats’ amendments were offered, initially rejected, but then approved on division votes in the Senate Committee of the Whole. That was despite the objections of a majority of the Republican caucus, who watched helplessly as Crandall, Pierce and Worsley joined with the minority party to approve most of their wishes.

House Republicans crossed over from their chamber to watch the voting take place, getting a glimpse of what could transpire in their chamber next week.

Rep. J.D. Mesnard, R-Chandler, said House Speaker Andy Tobin would not allow his chamber to be taken over by a mix of House Republicans and Democrats.

“At the end of the day there’s a big difference between the House and the Senate, and that is the speaker is not going to get rolled. So we’re going to sit down in leadership and talk about what happened here in the Senate, and then try and figure out where we go from here, what our members want to do,” Mesnard said. “Momentum or not, it can be stopped by one person alone over there.”

Evidence of dissent in the majority party became evident in caucus, when some suggested starting over next week due to the disagreement on Medicaid expansion. But even setting aside the debate over that, senators also disagreed about the final shape of the rest of the budget.

And some suggested that if the Senate fails to pass a budget today, senators will have to start anew with discussions and negotiations and then try again next week.

Biggs warned his colleagues that adding at least $57 million in spending over three years could blow up the entire spending package.

Biggs referred specifically to efforts by fellow Republicans to add or expand spending in various areas, such as money for adult education and school safety. Taken together, they would substantially increase the state’s expenditures.

Assessing the situation, Sen. Rich Crandall, R-Mesa, said the leadership-backed budget, which the Senate Appropriations Committee passed on May 15, doesn’t have sufficient votes to pass in the chamber.

He said that leaves the Senate with three potential resolutions: Modify the budget to get 16 Republican votes, work on amendments to get the support of enough Republicans and Democrats to pass it, or “start over.”

“The challenge is what amendments [will] get us 16 votes?” Crandall said, adding, “We’re going to have to do some work to get this through.”

Sen. Don Shooter interjected, telling colleagues that a “path” exists to resolve the big issue of the day – Medicaid expansion. If everybody cooperated, that path could mean the least damage to the state and to them politically, he said.

But Biggs wasn’t convinced.

The president, who is clearly opposed to increasing spending in the budget, reminded senators that the current plan is the result of hours of work by legislative staffers, and the amendments would “change [the budget’s] nature.”

“We can talk about paths to victory, but there is no path to victory for everybody at this table,” he said.

Meanwhile, the Democrats succeeded in adopted amendments including $9 million for Child Protective Services, $875,000 for Navajo Technical College and funding for the Arizona State Parks Board and Arizona Arts Commission.

A plea came Ward during the morning caucus for Republicans to unite.

“I would like to see our caucus come together as a caucus,” Ward said. “I’m tired of seeing Republicans picked off to vote for a Democrat budget.”

But Hobbs said Republicans were finally getting a taste of their own medicine. Democratic amendments are routinely shot down by majority vote in the Senate.

“We’ve also been able to show how tenuous their majority is. That’s a win right there,” Hobbs said.

Whe said some of those measures would likely be stripped out in the House.

Assistant editor Luige del Puerto contributed to this article

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