Despite vigorous objections from Democrats, Republican-controlled House and Senate panels on Wednesday quickly moved to give Gov. Jan Brewer the authority to ask for the federal government’s permission to drastically scale back subsidized medical coverage for its residents.

Brewer is seeking the federal waiver as part of her budget plan, which cuts funding to the Arizona Health Care Cost Containment System by $542 million. The proposal will drop about 280,000 people from the state’s Medicaid program.

Without the waiver, the plan would violate the federal health care overhaul that Congress approved last year. Brewer is asking for a two-year suspension of the health care law’s requirements to maintain spending and eligibility levels for those who are enrolled in AHCCCS.

But Democrats argued that even if the waiver were granted, the proposed AHCCCS rollback would still violate state laws and ignore constitutional guarantees against legislative efforts to amend voter-approved spending programs.

Sen. Kyrsten Sinema, a Democrat from Phoenix, said it was voters who approved the expansion of the state’s medical coverage to people who earn less than 100 percent of the federal poverty level.

Sinema’s argument: Arizona’s Constitution says that any tweak to a voter-approved spending program must further the intent of that initiative, and that three-fourths of the Legislature must agree to the change. Clearly, dropping 280,000 individuals from the AHCCCS rolls doesn’t further the program’s intent, Sinema said, and therefore it violates the Constitution.

“A federal waiver does not give this Legislature permission to ignore the will of Arizona voters,” Sinema said in the Senate Appropriations Committee hearing.

The committee passed SB1001 along party lines, 9-4. The House Appropriations Committee also passed HB2001 on a 9-4 party-line vote.

Final votes on the bills are expected on Thursday.

Sen. Andy Biggs, the chairman of the Senate Appropriations Committee, said the current spending level is simply unsustainable.

The Gilbert Republican anticipates lawsuits to challenge the AHCCCS rollback, but for him the legal question is how the state government will demonstrate that it doesn’t have other available sources for the Medicaid program.

“Does it mean you have to raid education, decimate them?” Bigg said. “Does it mean… that you have to raise taxes mightily in order to get the other available funds?”

The governor’s office and many Republicans contend that there is wiggle room in the 2000 proposition to scale back funding for AHCCCS. The proposition said revenues from a tobacco litigation settlement shall be used for the medical coverage expansion and “shall be supplemented, as necessary, by any other available sources including legislative appropriations and federal monies.”

The argument is that the state is in a crisis and therefore has no “available sources” for the program.

House Minority Leader Chad Campbell, however, argued that there are available funds. The fact that Brewer’s budget proposal includes increased funding for some agencies, such as the Department of Corrections, negates Republican arguments that there is no money available.

“We can’t say there are no available resources,” said Campbell, a Phoenix Democrat.

Biggs also said Arizona has a good case to make with the federal government. First, Arizona offers medical coverage that is more generous than most states have. Additionally, Arizona’s medical coverage actually exceeds the federal limits.

Many Democrats don’t see how the federal government would grant Arizona a waiver.

But neither does Sen. Ron Gould, a Lake Havasu Republican.

“This is just an effort in futility,” he said, adding the state has to go through the motion.

“We’re going to ask, and when they say ‘no’ then we’re going to have to come up with another option. But if we didn’t ask, would we really be justified in going to toss Medicaid back in (the federal government’s) lap?”

Several House Democrats bemoaned the tens of thousands of jobs that would likely be lost in the health care industry if the state cuts 280,000 people from AHCCCS. Debbie Johnston, of the Arizona Hospital and Healthcare Association that some hospitals, especially in rural areas, will be forced to make serious cutbacks.

Democratic Rep. Matt Heinz, a doctor at University Medical Center in Tucson, said the proposed cuts would force thousands to seek treatment at emergency rooms. Brewer’s budget proposal includes $150 million to offset the cost of uncompensated care for health care providers, but Heinz questioned whether it would truly cover the costs.

“It is tantamount to an unfunded mandate, is how I see it, because these services will still be provided,” Heinz said.

Heinz said the cuts would be especially perilous for such expensive services as trauma centers.

Johnston told the House Appropriations Committee that her organization has been contemplating other options for funding AHCCCS, but hasn’t found a solution yet. Campbell suggested a provider tax, which the association has opposed.

Emily Jenkins, of the Arizona Council of Human Service Providers, said the cuts could have unintended consequences as well. Eligibility for public housing is based largely on Medicaid eligibility, she said, and the 280,000 AHCCCS patients who lose coverage could lose their public housing as well.

That would be especially troubling for the 5,200 seriously mentally ill patients who are expected to lose coverage, Jenkins said. Under Brewer’s budget proposal, those patients would continue receiving state-funded medication. But without treatment, Heinz said, most of them won’t even take their medication, and would likely end up on the streets.

“We could end up with 5,200 unstable homeless people,” Heinz said.