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THE AHCCCS PUSH

After spending months building up public support, Gov. Jan Brewer unveiled her legislation to extend Medicaid coverage to Arizonans below 133 percent of the federal poverty line last week.

Brewer has been pushing the expansion of the Arizona Health Care Cost Containment System, or AHCCCS, since she delivered her State of the State address in January.

She and her allies—including most of Arizona's hospitals, a bunch of chambers of commerce and other biz organizations such as the Southern Arizona Leadership Council, and even the Arizona Sheriffs Association—say that the expansion will bring $8 billion from the federal government to Arizona in the first four years.

To make it work, however, Arizona has to come up with hundreds of millions of dollars in matching funds over those four years—which is where a voluntary assessment on hospitals comes in.

The hospitals, with a few exceptions, are willing to pay the assessment because they know that they'll get back a lot more in return once more of their patients have insurance.

It's no surprise that hospitals are willing to pony up that money. As AHCCCS Director Tom Betlach explained at a recent town hall in Tucson, hospitals have seen the cost of providing care for uninsured Arizonans double since the Brewer administration froze enrollment in the program for childless adults below 100 percent of the federal poverty line in an effort to balance the state's budget.

"And if we do nothing, then it will double again," Betlach warned. "And that will be felt by the consumers, the carriers and the businesses in this state."

At that same town hall, Brewer's policy advisor on health care, Don Hughes, said that the assessment would also free up $136 million in the state's general fund, "which can be spent on other priorities, such as K-12, universities, CPS, and public safety."

Brewer has included what she calls a "circuit breaker" to stop the program if the federal government lowers its share of the match below 80 percent.

"The Arizona Legislature won't have to take another step," Hughes said. "So if Congress and the White House lower the reimbursement rates, then it's an automatic repeal and the onus will be on the Congress and the White House. This sends a very clear signal to them that 'You may have your own budget problems, but don't think about balancing them on the back of the state.'"

But most Republicans in the Legislature have been cool to the idea and rank-and-file GOP activists have been downright hostile. Legislative districts and county parties across the state have been condemning the expansion as a way of supporting the federal Affordable Care Act—aka Obamacare—and a general assault on the principles that made our country great.

"Obamacare is going to have 46 percent of the American people on public health care," Rep. John Kavanagh, who chairs the House Appropriations Committee, told Phoenix 12 News political reporter Brahm Resnik over the weekend. "It unsustainable. The reason I oppose this expansion is that even though they've crafted it so there's no immediate cost to Arizona—although there is risk down the road—the American people can't afford this. ... This is going to bankrupt the country."

A few GOP lawmakers, however, are leaning toward supporting the proposal, as are legislative Democrats. If the legislation can get out of committee and to a vote of the full House and Senate, it can probably get more than 50 percent of the lawmakers to support it.

But that's where some of the legal trouble comes up. Any kind of tax increase requires approval of two-thirds of the Legislature. Brewer hopes to sidestep that requirement by saying the assessment is a voluntary fee administered by the AHCCCS administrator and not a tax—a novel way around the two-thirds requirement.

The proposal was set for a hearing in the House Appropriations Committee on Wednesday, March 20.

SPECIAL K

As of press time, Tucson City Councilman Steve Kozachik was set to formally kick off his reelection campaign Wednesday, March 20.

Kozachik planned to appear at downtown's Borderlands Brewing with four guys who have been elected mayor of this burg: Current Mayor Jonathan Rothschild and former mayors Bob Walkup, George Miller and Tom Volgy.

"Borderlands is the perfect venue for this kick-off," said Kozachik in a prepared statement. "It's the poster child of a successful private-sector venture that has quickly grown into a successful downtown business. It is emblematic of the successes we're seeing in the downtown core, a success story that I'm proud to have been a part of and one that I am excited to continue to support."

We would add that Borderlands brews a darn good beer.

But we digress. Kozachik has tapped three people to serve as honorary co-chairs of his campaign: Walkup, former Tucson City Council member Carol West (who left office as an independent after she got too much grief from the Pima County Democratic Party leaders for teaming up too often with the Republicans who were then on the council) and Democrat Richard Carmona.

Koz has already picked up endorsements from Tucson Police Officers Association, the Tucson Firefighters Association and the Pima Area Labor Federation.

It's a big change from four years ago, when an unknown Kozachik threw his hat into the ring to challenge Democrat Nina Trasoff. And while his margin of victory was narrow, Kozachik has pulled off an impressive trick: By being out in front of issues, speaking his mind and being willing to tangle with Republican state lawmakers, he's transformed himself into one of Tucson's most popular politicians.

Along the way, he's pissed off a lot of conservative Republicans, which is why he wisely switched parties in January. He doesn't have to worry about a GOP challenger in the Ward 6 primary and he'll easily win the votes of Democrats, independents and a reasonable number of what's left of GOP moderates in the November general.

So far, no one has come forward to challenge Kozachik.

SPEAKING OF RICH CARMONA...

Democrat Richard Carmona, who narrowly lost a U.S. Senate race to Republican Jeff Flake last year, told the press over the weekend that he won't be running for governor next year.

The announcement is a big boost for Democrat Fred DuVal, who announced his exploratory campaign for governor last month. At this point (and it's ridiculously early for 2014 speculation), the only other serious Democrat publicly considering a run is state Rep. Chad Campbell, but he can't announce his plans without triggering Arizona's resign-to-run law.

DuVal, who has worked in the Clinton White House and as an aide in Bruce Babbitt's gubernatorial administration, has been announcing a lot of endorsements lately. Earlier this week, he got the thumbs-up from three former members of Congress: Harry Mitchell, Karan English and Sam Coppersmith. Last week, it was more than six dozen Democratic officials and former lawmakers around the state, including Pima County Sheriff Clarence Dupnik and Pima County Attorney Barbara LaWall. The week before that, it was nine current Democratic lawmakers. You can expect more of this in the future as Duval works to sew up support and avoid a contentious and expensive primary race next year.

More by Jim Nintzel

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