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Republican Lawsuit Threatens Arizona's Medicaid Expansion

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AP Photo / Ross D. Franklin

The Lawsuit Can Now Go Forward

The Arizona Supreme Court ruled last week that the lawsuit could advance. It was brought by the Goldwater Institute, a conservative think tank that is representing 36 GOP legislators in the case.

Whether the plaintiffs had standing to challenge the state's expansion legislation had been the primary legal question thus far, reaching the high court. The case now returns to a lower trial court to be heard on its merits.

Was Medicaid Expansion Legal?

The basis of the case is this: Arizona's expansion plan included an "assessment" on hospitals that would help pay for the state's share of expansion costs. The Republican lawmakers argue that this should be considered a "tax" under the state constitution and therefore should have required a two-thirds majority to pass.

Per the New York Times, the expansion legislation initially cleared the state House, 33 to 27, and the Senate, 18-11, with less than a two-thirds majority.

New Governor In Office

Republican Gov. Jan Brewer spearheaded Medicaid expansion in Arizona, even threatening at one point to veto every bill that crossed her desk until the legislature passed it. Her office has also fought the new lawsuit. But Brewer is leaving office Monday.

Her successor, former state treasurer Doug Ducey (R), has not officially stated what his administration will do with the lawsuit. But during the campaign, he did not commit to repealing it.

Coverage For 350,000 At Risk

Per the Times, 250,000 Arizonans have already enrolled in Medicaid expansion and up to 350,000 are expected to eventually enroll. Because Obamacare does not provide tax subsidies to people below the poverty line, most of those people would likely to left without coverage if the expansion were reversed.

First Of Its Kind

Conservatives in other states like Arkansas have gone after their state's Medicaid expansion plans, thus far to no avail. If Arizona Republicans succeed in their lawsuit, it could set the state up to be the first to reverse course on the program.