Some Republican legislators are attempting to reverse Arizona's 2013 decision to expand the state's Medicaid program under the federal health care law, setting up a potential rematch with Gov. Jan Brewer and those who backed the expansion with majority votes in both chambers of the Legislature last year.
Republican Rep. Adam Kwasman of Oro Valley said a vote by the House Reform Human Services Committee on Thursday that advanced his House Bill 2234 is the first step in what may be a long fight by conservatives opposed to the expansion.
The bill is virtually certain to fail, because the coalition of Democrats and some Republicans Brewer assembled last year to push through her proposal remains in place. But Kwasman said his effort is important anyway.
"Even if it does not pass out of this Legislature, with this governor, we want to be able to continue to put pressure on, keep fighting that fight, so that after this Legislature and perhaps with a new governor we will be able to finally repeal this piece of legislation," Kwasman said.
The same committee also advanced a proposal by House Speaker Andy Tobin, House Bill 2367, that would add work requirements for those on the state's Medicaid program, institute co-pays for emergency room visits and limit free coverage to five years. Tobin's proposal would require a waiver of rules set by the Centers for Medicare and Medicaid Services.
"They've been making changes in Obamacare since they started," Tobin said. "The president's been issuing executive orders entirely changing the makeup of it. So at the end of the day I think it makes some sense to say let's continue this conversation about having co-pays and try to reduce the overall costs."
Tobin's proposal would affect even those who have full-time jobs but qualify for free health care because they earn so little.
"The idea is to say hey, after five years, is not 60 months long enough?" Tobin said. "Cash assistance is two years, unemployment has limitations, this is double, more than double what the cash assistance is."
Federal health officials could not immediately say whether such a waiver was possible or ever been issued to other states. Monica Coury, a spokeswoman for Arizona's Medicaid plan, called the Arizona Health Care Cost Containment System, said she is not aware of any state being allowed to impose work rules or a time limit on eligibility.
Arizona was allowed to charge $30 co-pays for unnecessary emergency room visits, but that expired Dec. 31. The state is currently asking federal officials for authority to charge $200 for such visits for newly eligible people.
Tobin and Kwasman are both seeking the Republican nomination in the 1st Congressional District.
Tobin said he would not support Kwasman's bill despite his opposition to expanding Medicaid because it can't pass.
"I think it's a fool's errand to run a bill that's going to have the same result that we had here last year," Tobin said.
Tobin and Kwasman are both part of an effort to have the Medicaid expansion thrown out by the courts.