Gov. Jan Brewer has insisted repeatedly during the past year that the Legislature has the authority to cut spending for Arizona’s Medicaid program below the level that voters thought they had locked 10 years ago. But she appears to have shifted strategy and instead may ask voters to approve the cuts in a special election.
While speaking to reporters on Nov. 29, Brewer said she may seek a special election to get voter approval for cuts to the Arizona Health Care Cost Containment System (AHCCCS). Many legal experts say the proposed cuts would violate Proposition 204, which voters passed in 2000 to expand Arizona’s Medicaid program.
“There’s a possibility we’ll have a special election,” Brewer said following the official statewide canvass of the Nov. 2 election at the Secretary of State’s Office. “That’s one of the options that we’re looking into.”
Brewer spokesman Paul Senseman said he believes the state could still make the cuts without getting voter approval. Senseman said Brewer may seek voter approval, “Just so it’s abundantly clear, legally.”
But Senseman did not say what led the governor to deviate from her longstanding message on Prop. 204, or why she would risk rejection at the polls if a special election wasn’t needed. He acknowledged that voter rejection of any AHCCCS cuts would likely nix the entire plan.
“I think what she’s saying is the option’s on the table. We really haven’t speculated beyond whether it may or may not succeed,” Senseman said.
Many legal scholars and attorneys said cuts to AHCCCS would likely be overturned by the courts. Not only that, but cuts to AHCCCS may put the state at odds, again, with the federal government.
Before Brewer can contemplate a special election, the state must get permission from the federal government to make the cuts, which would violate the health care law passed by Congress in March. The law includes a maintenance-of-effort provision that prohibits states from scaling back their Medicaid programs.
Brewer said she will seek a waiver from the federal government, which would allow the state to cut about $1 billion from the AHCCCS budget. Some Republican lawmakers said they will enact the cuts, regardless of whether the feds lift the maintenance-of-effort provision, but Brewer would not say whether she would veto such legislation.
“That’s hypothetical. I don’t know if I can move forward and give you an answer on that today,” Brewer said.
If Arizona made the cuts without permission, the federal government could retaliate by stripping the state of about $7.5 billion per year in Medicaid funding.