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Brewer Accepts Medicaid Expansion in Arizona: Daugaard Next?

Governor Dennis Daugaard's position on the Affordable Care Act's Medicaid expansion may be shifting a bit. In the pretty clear you-lazy-bums language of his budget address in December, he said expanding Medicaid is bad, bad, bad. But now he's saying he doesn't want to expand it "for now" because of uncertainty over federal funding.

Maybe Daugaard got an early memo from fellow Republican Governor Jan Brewer of Arizona: ObamaCare is here to stay, and expanding Medicaid is good for the states. In her State of the State address yesterday, the notably conservative Republican said she will sign Arizona up for the Medicaid expansion, saying it makes no sense to reject this opportunity:

Under the Affordable Care Act, if Arizona boosts eligibility to 138 percent Washington would initially pick up virtually all of the extra cost, eventually scaling back to about 90 percent. Brewer told Republican colleagues who control the state House and Senate it makes no sense to pass up those dollars.

"We will protect rural and safety-net hospitals from being pushed to the brink by growing their cost in caring for the uninsured,'' the governor said. Brewer said joining the federal program will create enormous economic benefit, inject $2 billion into the Arizona economy, save and create thousands of jobs and provide health care to hundreds of thousands of low-income individuals.

The governor said going along will save money. She said the costs of providing care to the uninsured are not simply absorbed by hospitals but passed along.

"Health care premiums are raised year after year to account for expenses incurred by our hospitals,'' she said. "This amounts to a hidden tax estimated at nearly $2,000 per family per year [Howard Fischer, "Brewer Address: Ariz. Should Expand Medicaid, CPS Efforts," East Valley Tribune (Tempe, AZ), 2013.01.14].

But what about that niggling uncertainty that the SDGOP wants to study oh-so-cautiously before submitting to Obama's tyranny? Nuts, says Governor Brewer:

Conversely, Brewer said it won't raise taxes in Arizona.

She said the state's share will be paid for by a "bed tax'' on hospitals. And Brewer said if Washington cuts funding, the state law would including a "circuit breaker'' to automatically roll back enrollment [Fischer, 2013.01.14].

Governor Brewer just destroyed the last reasons Governor Daugaard could offer for balking at the cost-saving, life-saving Medicaid expansion. If a conservative firebrand like Governor Brewer can say Governor Daugaard's position "makes no sense" and embrace the Affordable Care Act, then Governor Daugaard can, too.

President Obama has won. ObamaCare has won. Let's bury that argument (Brewer's action signals the GOP realizes campaigning against ObamaCare is no longer a winning argument) and adopt good policy for South Dakota.


  1. Dana P. 2013.01.15

    Wait. A. Minute.... huh?

    "Brewer said joining the federal program will create enormous economic benefit, inject $2 billion into the Arizona economy, save and create thousands of jobs and provide health care to hundreds of thousands of low-income individuals."

    But I thought that "Obamacare" was a job killing, job destroying, monster-in-the-closet-waiting-to-gobble-you-up proposal!!!

    Yep, you are right Cory. Sounds like "they" have gotten the memo on this. Governor Martinez - NM, and Governor Sandoval - NV, have also seen the wisdom in expanding Medicaid in their states. Only 10 governors are still holding out! I don't think Gov D wants to be the last one - or does he?

    Maybe if the "get on board Obamacare memo" is served with cheese, he will pay more attention.

  2. Wayne Gilbert 2013.01.15

    George Costanza put more study into Breakfast at Tiffany's for his book club than the Governor and the Speaker will put into Obamacare before they come out and say they are still rejecting it.

  3. caheidelberger Post author | 2013.01.15

    Wow, Larry! Says Governor Jack Dalrymple in that article: "We try to leave the politics out in the hallway when we make these decisions. In the end, it comes down to are you going to allow your people to have additional Medicaid money that comes at no cost to us, or aren’t you?... We’re thinking, yes, we should.”

    Yes we should! Is South Dakota going to be the last state to come to its senses?

  4. caheidelberger Post author | 2013.01.15

    Steve, I just heard that the House passed a $50-billion Hurricane Sandy aid bill. The Republicans obviously aren't worried about the debt ceiling. You're shooting blanks.

  5. Jerry 2013.01.15

    Don't give up on ole Denny yet and say that he is coming on over from the dark side. There is still plenty of time to milk this before it starts to sour. You are acting as if Denny may have some smarts, you should know better. I am thinking that he will go with the Feds running things, just like he intends to do with the Exchanges. No, Denny is not a leader by any means, he is a follower of tea leaves.

  6. lrads1 2013.01.15

    I am impressed and encouraged by the news of Gov. Dalrymple and Gov Brewer's decisions. They are bringing a dose of reality to their states and bucking some seriously rabid anti's in their legislatures, something we haven't seen yet here in SD--other than a "well, we'll take the legislature's opinion into consideration if they decide to decide." This governor spent his political capital on more important things, like grabbing education money for big business bribes and tearing school faculties apart with bonuses based on who can teach to the test the best.

  7. Michael Black 2013.01.16

    Maybe Gov. Daugaard has good reason to be cautious. Cory, if you haven't noticed, House Republicans are now chanting that they won't negotiate with the President when it comes to spending cuts (entitlement reform) in debt ceiling legislation. The debt limit and the continuing resolution allowing the government to spend money both run out by the end of March.

    Is it wise for our state government to commit to Medicaid expansion when we don't know if federal funding will be coming?

    We can look to the Lewis and Clark Water Project as an example of the feds not spending the money they have already committed.

    We will have to see if the can gets kicked down the road again and we have another budget showdown in a few months or if Congress actually deals with the fact that we spend far more money than we take in. Either way, entitlement programs are going to see painful cuts.

  8. caheidelberger Post author | 2013.01.16

    Michael, please tell me how Governor Daugaard can see need for caution here when governors of at least as stiff a Republican pedigree as he are signing up. Is he reading things that Govs. Brewer and Dalrymple are not? Making long-term policy based on the GOP's current debt-ceiling kamikaze act seems short-sighted. If we have long-term budget concerns, why not include the Brewer circuit breaker in the authorizing legislation?

  9. caheidelberger Post author | 2013.01.16

    Take a cue from L above: Arizona and North Dakota are recognizing that we need to drop the politics and simply enact a sensible policy that will do good for South Dakotans.

  10. Michael Black 2013.01.16

    If I can't justify spending any money in our business for expansion because of economic uncertainty soon to be caused by Congress, why would others do so?

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