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Governor Jan Brewer’s plan to expand access to healthcare for the poor in Arizona got its first hearing in front of the legislature Wednesday, two months after the governor first proposed growing the state’s Medicaid program. Arizona’s House Appropriations Committee – the money people in the house of representatives – heard from the legislature’s number crunchers about what costs, exactly, would come from Brewer's plan.

As yet, no legislation has officially been proposed so the numbers the committee heard were based on the draft legislation Brewer hopes the House and Senate will take up. 

Most of the money from Brewer’s proposal will go to making federally-mandated increases to the state’s Medicaid program under President Obama Affordable Care Act.  But there are additional changes Brewer wants to make that will expand healthcare access to the state’s poor.  Those changes will cost Arizona nearly $200 million dollars BUT they will bring in about $1.7 billion from the federal government.

The coverage would include adults in a family of four who make less than $31,000 a year. It would also restore coverage for low-income childless adults — there’s been a freeze on new enrollment for that group since 2011. All told, it would add at least 300,000 people to Access and pay for the majority of it with federal funds.

That last bit – the federal funds – really roils House Appropriations Committee Chairman Jon Kavanagh.

"The federal government can’t afford this, Arizona's citizens are also U.S. citizens, we can’t afford this," Kavanagh said. "We’re on our way to becoming a third-rate power like Greece, and it just has to stop."

He says costs to Arizona from the program are likely to go up down the road because the feds may reduce the funds they offer states. 

The governor’s plan does include a so-called circuit breaker that would undo the expansion if the federal government decided to foot less than 80 percent of the state’s Medicaid budget.

Medicaid is paid for by a combination of federal and state funds, and Arizona’s part of the tab on these proposed changes would come from fees on hospitals. Those details haven’t been outlined yet. But Kavanagh doesn’t like them either.

"The scam hospital bed tax where hospitals get taxed to get more money for themselves, that was identified as a gimmick which is driving the federal government broke," he said.

The hearing was also the public’s first chance to give formal feedback. And they did, for more than four hours. Some agreed with Kavanagh. Others, like Mary Jorgensen from St. Vincent DePaul, which runs health and dental clinics for the poor, said it’s the right idea. 

"Everyday we all see the people who have lost their health insurance," Jorgensen said, noting that they’ve seen the number of uninsured people asking for help from the charity more than triple in the last two years. "It’s a moral issue and a financial issue. It's both things"

These and other issues that will keep coming up as the governor pushes fellow Republicans in the legislature to turn her proposal into law.