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Medicaid expansion lawsuit

See also: Can Arizona conservatives beat the clock to block Medicaid expansion from taking effect Jan. 1?

John Smith is one of the 36 Republican members of the state legislature who signed onto a lawsuit in September 2013 against Arizona Governor Jan Brewer with the conservative Goldwater Institute over the Arizona Medicaid Expansion.[1]

Following the U.S. Supreme Court ruling to uphold the Affordable Care Act in June 2012, Brewer, a Republican who had long fought for its repeal, ultimately broke ranks with her party on the issue of Medicaid.[2] She first publicly embraced Arizona's participation in the federally controlled Medicaid expansion during her 2013 State of the State address. In addition to conceding the futility of continued opposition to Obamacare in the wake of the Supreme Court decision and Obama's re-election victory, Brewer discussed the considerable popular support for expanding patient eligibility: residents had already voted twice to make the state government provide free care for everyone up to the federal poverty line.

By June, a Medicaid expansion law had obtained passage in Arizona, despite a reluctant Republican-led state legislature. The United Republican Alliance of Principled Conservatives responded by filing a referendum to block the Medicaid Expansion law from taking effect, but the referendum failed to collect the required 86,405 valid signatures to land on the November 2014 ballot before the September 11, 2013, deadline.[3]

The referendum option off the table, expansion opponents decided a lawsuit was the best available alternative. The suit was filed on the grounds that because the expansion would require participating hospitals to pay a set fee to the state to help compensate for future reductions in the federal subsidy, the law contains a tax and therefore its implementation under the control of the executive branch would violate the state law enforcing separation of powers. While the imposition of such a fee is an authority given to state agencies "over 80 times in the past five years,"[1] according to a Brewer spokesperson, critics insist that the fee's resemblance to a tax is too close for constitutional comfort, per Article 3, Section 22, the distribution of powers.[4]

The state's conservative interests, plus the 36 Republican members of the legislature who voted against Arizona's involvement in the federal government-controlled Medicaid reform, hoped to have expansion shut down before it officially went live Jan. 1, 2014, with eligible residents beginning to enroll as early as Oct. 1.