Medicaid Expansion: Been There, Done That

AFP Arizona

To all Arizona taxpayers and health care consumers:

When it comes to the fiscal costs and human damage of expanding Medicaid/AHCCCS under ObamaCare, we know that things will turn out badly.  How do we know?  Because we’ve been there, and we’ve done that.  Here is what past experience, here in Arizona and elsewhere, tells us about the proposed expansion:

1)   The Medicaid expansion will cost much more than projected.
2)  The expansion may do nothing to help low-income Arizonans — and could hurt them.
3)  The so-called “hidden health tax” won’t get fixed.
4)  Arizona must bargain hard to get a better deal.
5)  The disgusting ploy to gut Prop 108 taxpayer protections will lead to more tax hikes.

You can read more about each of those items below, and TAKE ACTION HERE.  And click onthis link for info about the health care freedom protest at the Arizona Capitol on May 15.

1)  The Medicaid expansion will cost much more than projected.

None of the promised fiscal results of Arizona’s last Medicaid/AHCCCS expansion (enacted by voters through Prop 204 in 2000) actually materialized.  Prop 204 backers promised that the AHCCCS expansion would save money in the state budget.  The Joint Legislative Budget Committee was somewhat wiser, knowing that the expansion would cost the state money.  The committee projected that covering the Prop 204 population would cost $389 million in 2008.  But the actual cost was $1.623 billion — four times as expensive as projected!

And of course, the projected $2 billion in federal matching funds is not “free.” Certainly not for federal taxpayers — including millions of Arizonans.  According to the Goldwater Institute’sChristina Corieri, if Arizona and 11 other fence-sitter States join the 18 States that have already said No to the ObamaCare Medicaid expansion, the country could save $609 billion by 2022. That’s real money — even in Washington!

2)  The expansion may do nothing to help low-income Arizonans — and could hurt them.

Several studies
 suggest that Medicaid may actually hurt its supposed beneficiaries, but there has been only one randomized study (the Oregon Health Insurance Experiment) comparing persons on Medicaid to persons having no insurance at all.  According to results released last weekthe study has so far failed to find any evidence that putting people on Medicaid saved any lives or made any improvements in several objective health markers (blood pressure, cholesterol levels, and diabetes).

Things will get worse in AHCCCS the longer ObamaCare goes without being repealed.  In Arizona, according to the Kaiser Family Foundation, 23 percent of doctors say they will not accept AHCCCS patients.  Combine large increases in the Medicaid population with a declining number of doctors, and the result will be longer waiting times for patients.  In medicine, longer waiting times often mean discomfort, disability and death.  Read more about the human cost of the Medicaid expansion HERE.

3)  The so-called “hidden health tax” won’t get fixed.

The proponents of the current Medicaid expansion estimate that there is a “hidden health tax” of $2,000 per family per year in higher insurance premiums caused by uncompensated care(uninsured or underinsured people using the emergency room).  13 years ago, backers of the Prop 204 Medicaid expansion made the same argument, claiming that the expansion was going to relieve the state’s uncompensated care problem.  But according to a Lewin Group study,uncompensated care in Arizona increased by an average of nine percent per year during the first seven years of the Prop 204 Medicaid expansion, and the average family’s health insurance premium increased from $8,972 in 2003 to $14,854 in 2011 – a 66 percent increase.

Before you believe the hospital lobby’s arguments about uncompensated care, be sure to read Christina Corieri’s latest post: Medicaid expansion will line hospitals’ pockets.

4)  Arizona must bargain hard to get a better deal.

The main reason Arizona’s Medicaid system (AHCCCS) is not as bad as that in most other States is that Arizona waited two decades to join the Medicaid program.  Because we held out, we were able to bargain for a better deal – a Medicaid program that has been better at controlling costs and has provided better options for patients than in many other States.

But Governor Brewer’s team has failed to even try negotiating with Obama’s department of Health and Human Services (HHS).  In its most recent message about the Section 1115 waiver, HHS said “we do not anticipate that we would authorize enrollment caps or similar policies” while still letting States get 2-to-1 matching dollars.  But of course, “we do not anticipate” is not the same thing as saying “No.”  Right now, HHS is in the position of having to negotiate with States, because 18 States have already said No to the Medicaid expansion, and 12 States are still on the fence.  At this point, we don’t know if HHS really means “No,” because the Governor’s team simply threw up the white flag and capitulated to the demands of the Obama Administration.

Further, the Governor’s cost projections are based on AHCCCS coverage under cookie cutter Medicaid rules – in other words, how much things will cost if we capitulate and run AHCCCS according to federal diktat, without negotiating for better ways to run the program.

5)  The disgusting ploy to gut Prop 108 taxpayer protections will lead to more tax hikes.

Proponents of the ObamaCare Medicaid expansion are trying to do an end-run around Prop 108, the most important taxpayer protection in the Arizona Constitution.  Under Prop 108, it is supposed to take a two-thirds majority of the Legislature to raise taxes.  But Medicaid expansion proponents want to allow an unelected bureaucrat at AHCCCS to raise state taxes (mainlyhospital bed taxes) by hundreds of millions of dollars per year — without a two-thirds vote of the Legislature!

In their efforts to squeeze a giant hospital bed tax (“provider tax”) through a tiny loophole in Prop 108, Governor Brewer and others are trying to pretend that the provider tax is not a tax — even though the provider tax is a TAX under the Social Security Act.  They are also trying to pretend that: the provider tax is not allocated according to formula, although it plainly is; the provider tax does not have a limit, although it is limited by federal law to six percent; and, we don’t know how much money will be raised by the tax, even though the Governor and some Legislators are building budgets around the expected revenue.

History shows that removing taxpayer protections inevitably leads to higher taxes.  If Arizona’s Legislators delegate to an AHCCCS bureaucrat the authority to impose gigantic taxes on hospital patients, they will kill Prop 108, clearing the way for other departments and agencies to raise taxes without getting approval by legislative supermajorities.

To block the ObamaCare Medicaid expansion and to stop the end-run around Arizona’s constitutional taxpayer protections, TAKE ACTION HERE. For more information about the May 15 health care freedom protest at the Arizona Capitol, go here.

For Liberty, Tom

Tom Jenney
Arizona Director
Americans for Prosperity
www.aztaxpayers.org

Arizona Republican Icon Barry Goldwater, Jr. Gives Voice to Efforts to Save Arizona Solar Choice

Tell Utilities Solar Won't Be Killed

Effort To Stop APS From Killing Independent Solar In AZ Takes To Radio

(SCOTTSDALE, Ariz.) Following in his father’s footsteps as a conservative trailblazer in Arizona, Barry Goldwater Jr. is standing up to utility monopolies to preserve Arizona’s rooftop solar industry.

The voice of T.U.S.K (Tell Utilities Solar won’t be Killed), Goldwater can now be heard valley-wide in a new radio commercial that urges energy consumers to stand up to Arizona Public Service (APS). Goldwater and T.U.S.K oppose efforts by APS to extinguish rooftop solar in Arizona by trying to eliminate a cornerstone policy called net metering.

To listen to the commercial click here. To learn more about T.U.S.K. visit www.dontkillsolar.com

Net metering ensures that customers with rooftop solar get fair market credit from APS for any extra power they return to the grid. Conservatives in Arizona have stood up for school choice and healthcare choice, and now they are standing up for energy choice.

If APS pulls the plug on net metering, thousands of jobs would be lost. Businesses would suffer. Schools that utilize net metering will be sending more tax dollars to APS. Consumers would pay more.

“Energy choice is the American way. It’s the Republican way. And it’s the way to energy independence,” said Goldwater. We can’t allow monopolies to end consumer choice by changing the rules at the Arizona Corporation Commission.”

Barry Goldwater Jr. served 14 years in Washington and amassed expertise in energy, the space program, aviation and defense and government procurement. Goldwater was particularly instrumental in all facets of energy policy and research and development, including authoring the Solar Photovoltaic Act.

T.U.S.K. believes that rooftop solar is similar to a charter school—it provides a competitive alternative to the monopoly. Monopoly utilities aren’t known for reducing costs or for driving business innovation, but the Arizona solar industry is. Solar companies have a track record of aggressive cost reduction in Arizona. The more people use rooftop solar, the less power they need to buy from the utilities. Energy independence for Arizonans means smaller profits for the utilities, so APS is doing everything it can to stop solar.

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Doug Ducey: Inside the Vault – An Update on Arizona’s Financial Health

Doug Ducey

2013 is off to a very good start!

We have a balanced budget, $2 billion in our operating account and another $450+ million in a savings account earning interest. Arizona is on firm financial footing and the Legislature is back to debating the merits of individual proposals and whether they deserve taxpayer support.

Yet, we’re still not out of the danger zone. If our revenue projections are slightly off or go on another spending spree, we could find ourselves into the same hole we’ve just crawled out of. I’m confident that the Governor and Legislature don’t want to head down that path.

I will continue to advocate for economic growth and financially responsible ideas within our state government. Two areas of particular concern for the long-term health of our finances are our public pension systems and our state debt – both of which are completely solvable situations.

In December 2012 the Defined Contribution & Retirement Study Committee completed a 2-year review of Arizona’s four retirement systems, which currently covers more than 581,000 employees, retirees, or former employees that have yet to retire.

The Pew Center for the States and the Laura and John Arnold Foundation produced a report for the Study Committee titled Arizona’s Pension Challenges in November 2012 highlighting a $13 billion shortfall between what should have been set aside to pay future pension benefits and what the state’s pension plans have on hand. In addition to a growing unfunded liability, the number of retired members in each of the four systems is growing faster than the number of new workers entering.

Much of the discussion surrounding any pension system revolves around complicated financial formulas. There is an equally important human element that must always be in the forefront; these pensions are for those who teach our children, police our streets, put out the fires, respond to medical emergencies, and keep the basic functions of government running.

We are fortunate that our pensions are in far better shape than many other states. That said, there are issues that require attention. Several reform options were explored by the Study Committee for policy makers to consider so Arizona can continue to strengthen and enhance those plans in order to protect the benefits to current retirees and employees that have earned them, as well taxpayers now and in the future.

The final report, as well as all the meeting minutes, presentations and research materials can be accessed here.

Equally as important is our state debt. In January the Joint Legislative Budget Committee (JLBC) delivered their annual report of Arizona’s State Debt and the status of other financial obligations to the Appropriation Committees in both the House and Senate. Although the Legislature has gone to great lengths to deliver balanced budgets and begin to save money in the “Rainy Day Fund” the past two years, there are several areas on the state’s balance sheet that still need to be addressed.

Arizona’s total outstanding state debt exceeds $8.71 billion; increasing significantly from $4.89 billion in FY 2007. We continue to defer $1.2 billion of payments annually and our General Fund Debt Service costs will rise from $302 million in FY 2012 to $373 million in FY 2014.

Our state debt is too high. Today it is manageable. For tomorrow, we need to address our debt and pay for the money we’ve borrowed and already spent before we continue to commit to new spending. The entire report, which includes debt retirement options and a listing of all lease-purchase/bonding issuances from FY 2003, can be accessed online here.

We need to keep up the momentum that our state government has generated in showing that we can live within our means and demonstrate financial responsibility. Together, as taxpayers and citizens, we can hold elected leaders accountable for the future costs of today’s decisions.

If you would like to know Arizona’s daily cash balance visit the Treasurer’s Office web site, or if you want more frequent updates and commentary you can follow me on Facebook or on Twitter.

Thank you for your ongoing support.

Sincerely,
Doug Ducey

Doug Ducey

Download the Q1 2013 edition of Inside the Vault.

The Actual Costs of Expanding Medicaid in Arizona – What Really Happened

The main argument being made to expand Medicaid dependency in Arizona is “to do the math.” Well the Texas Public Policy Foundation did the  math for what really happened in Arizona the last time Medicaid was expanded and here is the graph depicting the cost to Arizona. These numbers cover a six-year period beginning in 2002 and ending in 2008.

Medicaid Expansion

The actual cost of expanding Medicaid in Arizona

Here is the article posted on the Texas Public Policy Foundation website:

This article originally appeared in The Daily Caller on 3/21/2013. 

If state lawmakers really want a clear picture of what Medicaid expansion under Obamacare will look like, they should start with Arizona, where expansion was tried more than a decade ago — with disastrous results.

In 2000, Arizona received a federal waiver to extend Medicaid to all childless adults and parents earning less than 100 percent of the federal poverty level. This is nearly the same group that would be eligible for Medicaid under the federal health care law, except that Obamacare would include those earning up to 138 percent of the federal poverty level, a slightly larger group.

At the time, Arizona lawmakers and expansion advocates promised that expanding Medicaid would lower the uninsured rate, reduce uncompensated care costs, decrease the “hidden tax” on private insurance for uncompensated care, and save about $30 million a year in state funds.

These same promises — lower uninsured rate and reduced uncompensated care costs — are being made by those calling for Medicaid expansion in other states.

None of the promises came true. In fact, the opposite happened. Enrollment of parents was more than triple what was forecast, while enrollment of childless adults was more than double.

As a result, costs skyrocketed. Spending per enrollee was much higher than anticipated, especially among childless adults, who proved to be twice as expensive to cover as parents. By 2008, Arizona had spent $8.4 billion on Medicaid expansion — more than four times what had been forecast.

What about the promise that expansion would lower the uninsured rate? In 2002, about 18.7 percent of Arizona’s non-elderly population was uninsured. By 2011, that group had actually increased to 19.4 percent. Meanwhile, the percentage of Arizonans with private insurance dropped from 61.8 percent to 55.5 percent, while Medicaid enrollment grew far beyond what had been predicted.

When the recession hit in 2008, Arizona faced a budget shortfall and scaled back Medicaid benefits for childless adults, including organ transplantation. It later froze enrollment for that group, which dropped from 227,000 to 86,000.

Arizona Gov. Jan Brewer’s January announcement that she will support the Obamacare Medicaid expansion should not have come as a surprise. Arizona’s waiver expires in 2013, and the state had no choice but to go along with expansion. If it did not, the feds would likely not renew the state’s waiver, which would force some 86,000 people out of the Medicaid program and into the ranks of the uninsured.

The Arizona experience is not unique. In 2002, Maine implemented an almost identical Medicaid expansion — with almost identical results. Within two years, enrollment was more than double what had been forecast, with childless adults costing more than four times as much as parents. Between 2002 and 2011, the uninsured rate remained the same, while the share of those with private insurance shrank, from 66 percent to 59 percent.

Proponents of Medicaid expansion claim it will reduce the uninsured rate and therefore reduce uncompensated care costs. The hope and expectation is that federal expansion dollars will free up state funds and relieve taxpayers, much like advocates of expansion hoped for Arizona and Maine.

Earlier this month, Methodist Health Care Ministries and Texas Impact published an estimate of Medicaid expansion savings. At first glance the figures are impressive; some $900 million in state funds could be freed up for the upcoming biennium, according to the report. The groups’ earlier study claimed counties and local taxpayers could expect relief from having to pay for uncompensated care costs, which the report said would decrease dramatically with Medicaid expansion.

But these projections are in fact nothing more than thin hopes. In Arizona, uncompensated care costs increased by an average of nine percent each year after expansion, and in Maine charity care rose from $40 million in 2000 to $215 million 2011.

Other states that have toyed with expansion — Delaware, Oregon, Michigan, Utah — have all had similar experiences: costs and enrollment exceeded expectations, uninsured rates stayed the same or increased, and the number of people on private insurance shrank.

If states are the incubators and laboratories of public policy, then the results of decade-long experiments with Medicaid expansion are in. In Arizona, Maine, and everywhere expansion was tried, none of the promised benefits materialized.

If lawmakers in other states choose to go down the road of expansion, they now know what to expect: skyrocketing costs, huge enrollment growth, a static uninsured rate, and more — not fewer — uncompensated care costs. Just ask Arizona.

 

Brewer’s plan rejected and labeled unconstitutional by rank and file Republicans in LD10

“We are the rank and file grass roots of the Republican Party. …Aside from being Republicans we are Arizonans. The Voters of Arizona reject the state implementation of Obamacare.”

For immediate release:

Legislative District 10 GOP opposes Governor’s Plan for Obamacare Medicaid expansion.

The Republican Precinct Committeemen of Legislative District 10 unanimously passed a resolution

opposing Governor Jan Brewer’s plan to expand Medicaid at our monthly meeting on March 9, 2013.

We have considered the Governor’s March 6th appeal to support her plan, and the information she has

presented to date, but found them wanting:

· The Governor makes an emotional appeal suggesting that if we don’t support her plan to expand

Medicaid, people will die. That is simply not the case. Under Obamacare the Federal

government will directly subsidize private health insurance to those same people. Numerous

studies have shown that private heath insurance provides higher quality care than the

government run Medicaid program.

· Her plan fails to address reasonable alternatives such as the direct Federal subsidy of private

health insurance for the poor already provided for in the Affordable Health Care Act

(Obamacare), and other models such as Wisconsin’s Badgercare. There are alternatives which

minimize or avoid financial burden to the State of Arizona.

· Governor Brewer’s plan ignores and attempts to sidestep the Constitution of the State of

Arizona. It ignores the will of Arizona voters who passed Propositions 106 and 108 to oppose

the implementation of Obamacare in Arizona and to require a super majority vote to raise taxes.

· Her plan unduly benefits select special interests such as large urban for-profit hospitals but

inadequately considers the effect of the “hospital assessment” on small rural hospitals. It fails to

install audit procedures to prevent the hidden tax of “hospital assessments” from being cost

shifted to all Arizonans who use hospitals. Thus the Governor’s plan becomes another example

of the Affordable Health Care Act making health care less affordable.

·  The Governor cites support from 110 large corporate interests, governmental agencies, and

public service organizations, many of which will directly benefit from her plan. She does not

address the thousands of small businesses that will carry the brunt of the consequences and

oppose her plan, or the millions of Arizona Voters who have already told her NO.

We are the rank and file grass roots of the Republican Party. We stand with the other Legislative

Districts and County Party Organizations who have stood up to oppose the Medicaid expansion.

Overwhelmingly both the Republican Party leadership and the grass roots oppose the Medicaid

Expansion. Aside from being Republicans we are Arizonans. The Voters of Arizona reject the state

implementation of Obamacare.

Maricopa GOP Votes Down Medicaid Expansion in Arizona

March, 2013

A RESOLUTION OF THE EXECUTIVE GUIDANCE COMMITTEE (EGC) OF THE MARICOPA COUNTY REPUBLICAN COMMITTEE (MCRC) MARICOPA COUNTY, STATE OF ARIZONA

IN OPPOSITION TO

THE ARIZONA GOVERNOR’S PROPOSED EXPANSION OF MEDICAID (AHCCCS) IN SUPPORT OF OBAMACARE

WHEREAS, Arizona voters clearly expressed their will to reject implementation of the Affordable Care Act (Obamacare) and the individual mandate by amending the Arizona Constitution in 2010 via the Arizona Health Insurance Reform Amendment, Proposition 106; and

WHEREAS, the “circuit breaker” clause is insufficient to prevent out of control escalation of enrollment and the long term costs will cause severe financial hardship on Arizona’s budget; and

WHEREAS, the “assessment” on hospitals is actually a tax and a disingenuous attempt to subvert Arizona’s Constitution and legislative process requiring tax increases receive supermajority approval in the legislature; and

WHEREAS, the United States Supreme Court ruled that each State may reject the expansion of Medicaid and Insurance Exchanges, the two cornerstones of Obamacare, without which it collapses; and

WHEREAS, the best method to honor Arizona voters’ wishes to reject Obamacare is for each State to refuse implementation and allow Obamacare to fail; and

WHEREAS, supporting a government takeover of Arizona’s health care system, even to secure large amounts of federal funds, does not reflect the values of the Republican Party or the interests of the taxpayers of Arizona.

NOW THEREFORE BE IT RESOLVED by the Executive Guidance Committee of the Maricopa County Republican Committee, Maricopa County, State of Arizona, does affirm and declare our opposition to the Governor’s plan to expand Medicaid; and

BE IT FURTHER RESOLVED by the Executive Guidance Committee of the Maricopa County Republican Committee, Maricopa County, State of Arizona, demands that the Arizona State Legislators uphold the rule of law set forth by Proposition 108 requiring a supermajority vote in this matter; and

BE IT FINALLY RESOLVED by the Executive Guidance Committee of the Maricopa County Republican Committee, Maricopa County, State of Arizona, demands that the Arizona State Legislators stand with the people of Arizona in opposition to the Governor’s plan to expand Medicaid by defeating any bill to such ends.

Author: Eric Morgan, Chairman, LD22 Republican Committee

PASSED & APPROVED this 7th day of March 2013, by a vote of 26 (ayes) to 2 (nays) to 0 (abstentions) of the Executive Guidance Committee of the Maricopa County Republican Committee, Maricopa County, State of Arizona.

MARICOPA COUNTY REPUBLICAN COMMITTEE

MARICOPA COUNTY, STATE OF ARIZONA:

A. J. LaFaro

________________________________________

by: A. J. LaFaro, Chairman

Maricopa County Republican Committee

[Download Resolution]

Representative Warren Petersen Needs Your Help on Three Bills

I want to make you aware of 3 bills that I am concerned about.   Your involvement can make a big difference.  There is a great website called lifelibertyfreedom.com that will allow you to email all of the legislators of the House and let them know how you feel.
HB2060 – Censure Bill (link)
This bill will allow school board members to censure each other.  This could be a tool used to ruin the reputation of a conservative or a liberal school board member.  School board members should feel free to speak their mind and their concerns whether or not they are in the minority of the board.  Please email the legislature and tell them to vote NO on HB2060.  It will be voted on in the house tomorrow 2/14/13 at 1:30 pm.
HB2343 – Public Employees, compensation for union activity (link)
This bill prohibits taxpayer dollars to be used for union activity.  If you believe union dues and not taxpayer dollars should fund union activities then please email the legislature and tell them to vote YES on HB2343.  It will be heard in committee on 2/19/13.
HB2456 - Revenue allocation districts (link)
This bill passed out of committee and will soon go to the House floor for a vote.  This would allow town councils to draw boundaries around businesses and form a board that will tax the businesses.  The revenue from the businesses will be used by the board for “economic development”.  This bill is a dream come true for big business and the well connected to create taxing districts and then control the funds.  If you don’t believe in business taxing districts then please email the legislature and tell them to vote NO on HB2456.
Small businesses and individuals have little to no voice at the Capitol.  They can’t afford to hire a lobbyist to protect their interest.  We need your help.  Please pick the issues above that you feel are important and use lifelibertyfreedom.com to email every Republican legislator in the house to tell them how you feel.  It will be Republicans that decide if these bills pass or not.  Please do not attack any of the legislators sponsoring the bills but focus on the bill itself.
You can reach State Representative Warren Petersen online.

WSJ – Governor Brewer’s Spectacular Flip-Flop

The GOP’s ObamaCare Flippers

Reprinted from The Wall Street Journal

February 4, 2013

As D-Day looms for ObamaCare, one big question is how many states will sign up for its Medicaid expansion. The recent and spectacular flip-flop of Arizona Governor Jan Brewer is a case study in the political pressure and fiscal gimmicks designed to get states to succumb. It’s also a study in the arcane and perverse ObamaCare incentives that are intended to gather ever more health-care spending under federal control.

***

Arizona’s current Medicaid program is well run by the program’s standards—a low bar—but it is also too large. The program now finances one of every two in-state births and two of every three days seniors spend in nursing homes. Spending tripled in the last decade to $9 billion a year.

That’s despite $1.8 billion in cuts since 2009. The state fisc was such a mess that in 2010 Arizona Medicaid banned paying for several types of organ transplants. In March of that year, Ms. Brewer wrote to Mr. Obama calling the Affordable Care Act “a vast new entitlement program that our country does not have the resources to support” and also one that “makes our situation much worse, exacerbating our state’s fiscal woes by billions of dollars.”

Arizona argued before the Supreme Court that the Medicaid mandate was unconstitutional, anti-federalist commandeering—and seven Justices agreed it was “a gun to the head” and allowed states to opt out without penalty.

But so much for that. In her State of the State address last month, Ms. Brewer pulled a political 180°—or maybe 540°—and said expanding Medicaid would “inject $2 billion into our economy and “save and create thousands of jobs.” (Is Larry Summers moonlighting as a Brewer speechwriter?)

One secret of her switcheroo is Medicaid’s “matching rate” formula, in which the feds pick up 67% of Arizona’s existing spending and 100% (and later 90%) of the costs of ObamaCare’s newly eligible population. The state supposedly no longer needs to spend “billions” but merely an extra $154 million in 2014—then bank $1.6 billion from Washington, which her budget documents call “a return on investment of more than 10-to-1.”

Associated PressArizona Governor Jan Brewer

How can the state conjure such money from nothing? The answer is that Ms. Brewer and Arizona hospitals have cooked up a spending scheme to rip off national taxpayers to avoid even the $154 million the state would at first pay. The hospital lobby first floated this scheme in 2011 “for the specific purpose of generating matching federal Medicaid funds.”

Here’s how it works: Arizona will tax hospitals and insurers for the $154 million. Then it will return $154 million to the health industry via more Medicaid business that will cover the cost of the tax and then some. The money needs to make a round trip from providers to the state and back to providers to game that 67% federal matching rate.

So Arizona takes (say) $3 from a hospital and then turns around and pays the $3 back, using one of the hospital’s own dollars that Arizona converted to “revenue” plus two dollars courtesy of Washington for its 67% federal share of the $3 payment. Arizona can then use the hospital’s remaining $2 of the original $3 to pay for another $6 of Medicaid expansion.

Some 49 state now use this trick of so-called provider taxes to goose federal spending, up from 21 in 2003. (Alaska is the exception.) But the practice is so abusive that even Mr. Obama proposed new limits in his last two budgets.

This subsidy honeypot can’t last forever, which is why other Governors are more skeptical about this Obama Medicaid windfall. When the money inevitably runs out, states will retain permanently larger obligations and lose budget autonomy for a generation or two as health care crowds out other priorities like education and roads.

Ms. Brewer was nonetheless besieged by health-industry lobbying, especially from hospitals that want more government money and the insurers that administer Medicaid. The campaign is orchestrated by Chuck Coughlin, Ms. Brewer’s former political strategist, and Peter Burns, a former Brewer budget consultant.

Providers are especially powerful at the state and local level, and the goal now is to rush the Brewer-Obama condominium through the Phoenix legislature with little debate. A particular offender is the Arizona Hospital and Healthcare Association, a trade group whose 2012 agenda includes “Oppose Taxpayer Bill of Rights-style legislative referendums or bills that arbitrarily limit state spending.”

Ms. Brewer’s other rationale is that everybody else is doing it, and that if Arizona opts out of a larger Medicaid then “Arizona’s tax dollars would simply be passed to another state.” Well, no, Washington would simply spend less money that it doesn’t have. In any event Arizona is already a net tax beneficiary—pulling down $1.19 from the feds for every dollar it sends to D.C., according to the Tax Foundation.

Ten other GOP Governors have rejected Mr. Obama’s Medicaid bribe, with another 20, Democrats and Republicans, undecided. Twenty are expanding, including Republicans Brian Sandoval of Nevada, Susana Martinez of New Mexico, Jack Dalrymple of North Dakota and even, on Monday, Ohio’s John Kasich. Thus does modern government create the carrots and sticks of ever-larger government.

 

 

Victory! We Beat the Arizona Obamacare Exchange!

AFP Arizona

Dear Arizona Taxpayer:

The Arizona chapter of Americans for Prosperity is grateful to Governor Jan Brewer for rejecting the state-funded ObamaCare/PPACA Exchange and thereby protecting Arizona businesses, taxpayers and health care consumers.  As Governor Brewer noted in her news release on the topic, a state-funded Exchange would be very expensive for Arizona taxpayers, and the federal government “would maintain control over virtually every aspect of our Exchange.”

AFP-Arizona is also grateful to all of the Arizona Legislators who stood their ground against the state-funded Exchange in the face of intense lobbying pressure from corporate interests that had been bought off by ObamaCare’s system of government mandates and subsidies.  Further, AFP-Arizona is grateful to its donors for supporting usthrough this long fight, and we are grateful for the policy advice afforded to us by members of our coalition, including the Goldwater Institute and the Cato Institute.  Finally, and most importantly, AFP-Arizona is grateful to the thousands of grassroots activists in Arizona who took action against the Arizona Exchange by writing emails, making phone calls, and confronting elected officials at public meetings — more than anything else, their activism won this battle.

The fight to contain and control the wide-ranging damage of the ObamaCare legislation is far from over, and AFP-Arizona is now ready to fight ObamaCare’s hugely expensive (but optional!) Medicaid expansion here in Arizona.  But it’s important to take the time to celebrate our victories, so we will soon send out an invitation for an upcoming Victory Party for all of the activists and elected officials who fought the ObamaCare exchange.  At the party, we will also celebrate the decisive victory of Arizona taxpayers over the Prop 204 sales tax hike on the November 6 ballot.

And on the topic of Prop 204, AFP-Arizona wishes to express our deep gratitude to Governor Brewer for taking a firm stance against the permanent one-cent sales tax hike.  Governor Brewer promised Arizonans in 2010 that her intention was for the Prop 100 sales tax hike to be a temporary expedient, and she kept her promise.

For Liberty,

Tom Jenney
Arizona Director
Americans for Prosperity
www.aztaxpayers.org
tjenney@afphq.org

Governor Jan Brewer Refuses to Burden Arizona Families and Small Business Through Health Care Exchanges

Statement by Governor Brewer
Too Many Questions, Costs with State Health Exchange

Today, I notified the U.S. Department of Health and Human Services (HHS) that the State of Arizona will not create a state-based Health Exchange. This decision comes following an extensive research and outreach process during which my team of health advisors conducted public hearings and met with HHS, patient advocates and representatives of Arizona hospitals, health providers, insurers, tribal groups and other members of the health care community.

This has been one of the more difficult decisions of my career in public service. My opposition to the Affordable Care Act (ACA) is unwavering, as is my belief that it should be repealed and replaced with legislation that achieves its stated goals: to improve access to quality, affordable health care in this country. But I am also aware that the ACA remains the law of the land. Likewise, though I am a steady advocate of local control, I have come to the conclusion that the State of Arizona would wield little actual authority over its ‘state’ Exchange. The federal government would maintain oversight and control over virtually every aspect of our Exchange, limiting our ability to meet the unique needs of Arizonans and the Arizona insurance market.

A state Exchange would be costly. Though the federal government has pledged to pay nearly all startup costs, states that form their own health exchanges are on the hook for operational expenses beginning in 2015. Those costs could total $27 million to $40 million annually for the State of Arizona, according to a recent study conducted by Mercer. Of course, these expenses would be passed along in the form of fees resulting in higher health premiums for Arizona families and small businesses. This would be an additional financial burden at a time when so many Arizonans are still struggling.

Lastly, there simply remains too much we don’t know about how a State-based Exchange would function and its ultimate cost to taxpayers. Without clear federal guidance and instruction, I cannot in good conscience commit the taxpayers of my state to this costly endeavor.

The State of Arizona has a long history of health care innovation. Our Medicaid program, AHCCCS, has been a national model of cost-efficient care for three decades, and our pioneering pursuit of integrated health is designed to improve the quality of life for Arizonans living with serious mental illness. In this proud tradition, I remain committed to working with legislators to enact State reforms that improve care and reduce costs for Arizona families, while maintaining a vibrant and competitive health care marketplace.

Read the statement here.

Hugh Hewitt: Memo to the States’ Governors and AGs on The Decision On Obamacare’s Exchanges: Go Churchill Or Go Home

By Hugh Hewitt
So brilliant needed to be reposted from Townhall.com.

With the president mobilizing for a barnstorming tour in support of massive tax hikes and to, in effect, overturn last week’s vote to keep the House in GOP hands and the gavel in John Boehner’s –details here on the president’s plan– the GOP is getting organized in the House and laying down markers.

The media is focused on speculation about the “big deal” and the various scandals, but a huge story is brewing that few are watching.

The deadline for the most important political and legal decisions of the near term is being made in every state: Whether or not to establish a state health insurance exchange pursuant to Obamacare. The original deadline for each governor to decide was this Friday, but HHS has graciously given the states another month to decide which poison to pick: Subservience via establishment of a puppet exchange or takeover of the state’s insurance business via a big foot federal health exchange. The rules the feds have dictated the states must follow in making their choice are here.

Yesterday, Governor Robert Bentley of Alabama announced that Alabama would not be establishing the exchange or expanding Medicaid. The latter is not surprising, as the expansion will quickly eat away at state budgets.

But Bentley’s position on the exchange –he joins at least Alaska, Florida and Texas in just saying no– is very welcome and hopefully a model for other Republican governors who must by law indicate their decisions on the exchange set-up by mid-December. Other states ought also to study the example set by Oklahoma, and sue to overturn the Hobbesian choice on exchanges being forced on them.

Only one state lawsuit against the forced choice on health exchanges has been filed –by the Sooners’ AG, and the amended complaint is here– and the national opposition to Obamacare should be looking for other governors to say no and other attorneys general to file similar challenges to the health exchange jam down.

The amended complaint of the State of Oklahoma argues in crucial part:

 

II. The New Claims 

8. In addition to that claim, Plaintiff raises new claims seeking declaratory and injunctive relief with respect to final federal regulations (the “Final Rule”) that were issued under Internal Revenue Code Section 36B, as added by Section 1401 of the Act, while proceedings in this action were stayed. The Final Rule was issued in contravention of the procedural and substantive requirements of the Administrative Procedures Act (“the APA”), 5 U.S.C. § 702; has no basis in any law of the United States; and directly conflicts with the unambiguous language of the very provision of the Internal Revenue Code it purports to interpret.

9. More specifically, Sections 1311 and 1321(c) of the Act allows States to choose to establish an “American Health Benefit Exchange” to operate in the State to facilitate execution of the Act’s key provisions. If a State elects not to establish an Exchange under Section 1311, Section 1321(b) authorizes the Secretary of Health and Human Services to create an Exchange to operate in that state.

10. Under the Act, this choice has important consequences for the State’s people and the State’s economy, because health insurance premium tax credits for low-income employed individuals and employer obligations under the Act both depend on which alternative the State chooses. If the State elects to establish its own Exchange, the Federal Government will make “advance payments” of premium tax credits to insurance companies on behalf of some of the State’s residents to subsidize health insurance enrollment through the State-created Exchange, but the payment of the subsidy for even one employee triggers costly obligations on the part of the employer that would not be triggered in a non-electing State, placing the electing State at a competitive disadvantage for jobs and job growth.

11. The Act leaves this policy judgment to each State and provides a mechanism for each State to choose the alternative it thinks is better for its people. The Final Rule upsets this balance by providing, contrary to the Act, that qualifying taxpayers are eligible for premium tax credits and “advance payments” if they enroll for health insurance through the Exchange where they live, regardless of whether it is a State-established Exchange or an HHS-established Exchange. Thus, if the Final Rule is permitted to stand, federal subsidies will be paid under circumstances not authorized by the Congress; employers will be subjected to liabilities and obligations under circumstances not authorized by Congress; and States will be deprived of the opportunity created by the Act to choose for itself whether creating a competitive environment to promote economic and job growth is better for its people than access to federal subsidies.

12. Oklahoma has not established or elected to establish an Exchange, and does not expect to do so. As a result, under the plain terms of the Act, employers in Oklahoma should not be subject to the Employer Mandate because of a determination that an Oklahoma resident employed by the employer in Oklahoma is entitled to advance payment of a premium tax credit because of enrolling for coverage through an Exchange established by HHS to operate in Oklahoma. However, the Final Rule purports to make such an individual eligible for a premium tax credit based on enrolling for coverage through an Exchange established by HHS to operate in Oklahoma, with the result that an Oklahoma employer employing such an individual will be exposed to liability under the Employer Mandate under circumstances not provided for under the Act. Thus, Plaintiff seeks declaratory and injunctive relief declaring the Final Rule invalid.

 

This is a narrow argument aimed at a specific rule, but there are other arguments to make, including the damage done to federalism when, upon saying no, the enormous supertanker of Obamacare sails into a state’s legal harbor via the federal exchange and smashes all the docks and other ships, displacing not merely the opportunity to run an exchange but destroying countless other state-administered relationships and regulatory balances.

States have to defend themselves against the giant takeover of states’ powers and duties by Obamacare. The decision to “just say no” so has to be taken by mid-December. Encourage your governor to say no and to sue alongside of Oklahoma, perhaps engaging one of the country’s leading experts on structural federalism like Georgetown’s Randy Barnett or my own colleague at Chapman John Eastman to make the arguments to preserve the state’s legislative integrity and their independence from D.C. Not only is this the right way to proceed for a state intent on protecting its citizens from an ever-expanding federal government, it may also present the Supreme Court with a second bite at the Obamacare apple via a different set of issues not dependent on the “is the penalty a tax” debate.

Some states are tired of the fight and their law departments not eager to spend another year battling the DOJ.

But that isn’t their choice. That choice belongs to their governor and their attorney general. Those who don’t choose to fight now cannot expect conservatives to fight for them in the future. Go Churchill or go home.

The status of states’ decision-making on the exchanges is reviewed on a state-by-state basis here.

The left is attempting to declare the Obamacare fight over. It isn’t. It is a 15 round fight. Conservatives won rounds when they elected Chris Christie, Bob McDonnell and then Scott Brown after the debate was begun. The left won a round when the law passed was passed, and it won a round when the Supreme Court upheld the individual mandate, but conservatives won in that opinion as well, on Medicaid and on the reach of the Commerce Clause.

The left scored a knock-down with the president’s re-election, but the fight isn’t over if the conservatives opposed to the law get up off the canvas and fight on. Oklahoma has, and some states have joined them, though not yet in the courts. They should, and soon. Obamacare was nightmare before the election, and it is a nightmare still. The president’s re-election was manifestly not about Obamacare, and the decision is not final and won’t be until every good argument is made and every opportunity given the Supreme Court to review the law in full.

Even if the legal fight should fail, it is important for federalism that many states pass on becoming puppets of the feds via the state exchanges. The fiasco-in-waiting of the federal exchange should be on the president’s head, with blame not easily shifted to bungling governors. The president broke it, so he should buy and operate it.

But only after every argument has been made, and the Supreme Court offered the opportunity to rule on the law as a whole.

ACT NOW to stop the Prop 204 Tax Hike

AFP Arizona

URGENT Action Items Below

Dear Arizona Taxpayer,

AFP-Arizona Needs YOU to help us defeat Proposition 204!

While current polling shows that Arizona voters are prepared to reject the Prop 204 tax hike on Tuesday, we must keep the heat turned up in the last days before the election.

The facts on Proposition 204 are simple:  It makes the temporary sales tax increase PERMANENT, which would cost Arizona taxpayers an additional $1 billion per year and potentially cost the state 15,000 jobs.  Arizona families are already hurting in a bad economy, and this is worst time to raise taxes and harm economic growth. Prop 204 also provides an already bloated education bureaucracy – Arizona’s total education spending has increased over 60% in the last decade, even as a smaller percentage of funds has gone to the classroom – with even more money, while failing to provide real reform to Arizona’s education system.

PLEASE TAKE ACTION!

AFP-Arizona is asking you to do the following:[1]

• Take whatever NO on 204 yard signs you may have to your nearest polling location on Monday night (Nov 5).

• Take any extra NO on 204 yard signs you may have to key polling locations (use the email below to ask Bill where your closest key locations are).

• Hand out anti-204 literature at your nearest polling place on Tuesday (use the email below to ask Bill for a printable version of AFP-AZ’s anti-204 talking points).

•  Per Arizona law, no materials (yard signs, literature, etc.) may be distributed or placed within 75 feet of polling locations.

Please contact Bill Fathauer AS SOON AS POSSIBLE at 480-332-0477 orbfathauer@afphq.org to volunteer for these actions.  (If you contact Bill today, or over the weekend, you will help us reduce our workload on Monday and Tuesday.)  Even if you can only volunteer for an hour or two, your help will be vital in stopping a massive tax hike that will damage the Arizona economy.

Thank you and keep up the good fight!

For Liberty, Tom

Tom Jenney
Arizona Director
Americans for Prosperity
tjenney@afphq.org
(602) 478-0146



[1]AFP-Arizona is independently asking its activists to take these actions to oppose Proposition 204. AFP-Arizona is not a sponsor of the No on 204 campaign, nor is it acting in coordination with the No New Taxes, No on 204 ballot committee.

No New Taxes, No on 204 Releases “5 Reasons”

No on 204

PHOENIX — No New Taxes, No on 204 today released its newest television advertisement titled, “5 Reasons.” Business and community leaders across the state all agree that the $1 billion permanent sales tax burden that Prop 204 will place on hardworking families and small business owners is bad public policy. Although there are 100 things wrong with the initiative, the top five reasons are highlighted in this 30 second spot.

YouTube Preview Image

Script For “5 Reasons:”

VIDEO TEXT: 5 REASONS TO VOTE NO ON PROP 204

VIDEO TEXT: 1 – LARGEST PERMANENT TAX INCREASE IN ARIZONA HISTORY
1 BILLION DOLLARS EVERY YEAR

ANNOUNCER: “5 reasons to vote no on Prop 204. 204 is the largest permanent tax increase in Arizona’s history.”

VIDEO TEXT: 2 – SECOND HIGHEST SALES TAXES IN AMERICA

ANNOUNCER: “Arizona would have the second highest sales taxes in America.”

VIDEO TEXT: 3 – NO EDUCATION REFORM

ANNOUNCER: “Groups all across Arizona say 204 has no education reform.”

VIDEO TEXT: 4 – WRITTEN BY SPECIAL INTERESTS IN SECRET

ANNOUNCER: “204 was written by special interests in secret.”

VIDEO TEXT: 5 – ARIZONA REPUBLIC STRONGLY OPPOSES

ANNOUNCER: “And The Republic opposes 204 saying it:

“…is bad public policy…burdening the poor far more than the well-to-do…”

VIDEO TEXT: VOTE NO ON PROP 204

VoteNOon204.com

ANNOUNCER: “Vote No on 204.”

To learn more about Proposition 204, please visit www.VoteNoOn204.com.

###

Five Reasons to Vote NO on Proposition 204

The No New Taxes, No on 204 campaign committee released the following new ad this morning. The ad takes 30 seconds to describe five reasons why Arizona voters should vote NO on the proposition.

YouTube Preview Image

 

Proposition 204 is More Trick than Treat

No on 204

Dear Friends,

Over a year ago, proponents of Prop 204 thought that their special interest funded ballot initiative would pass without protest. Now, as the campaign heads into its final week, Prop 204, the $1 Billion dollar permanent tax increase, is more unpopular than ever.

Proponents of Prop 204 thought their taxpayer giveaway would go unchallenged, but because of you, polls are showing that Arizonans are not interested in an initiative that does not promise real reform, accountability, or oversight. The message that Prop 204 is bad for Arizona families and business is spreading throughout the state.

We are grateful for the momentum that has been created by community activists, elected officials, and business leaders who have publicly opposed and continue to fight this horribly misguided ballot initiative.

The coalition to defeat Prop 204 grows by the day. The list is made even more impressive by your continuous support and effort. Even the Arizona Republic agrees:
“While the intention may be laudable, the likely unintended consequences of Prop. 204, the largest permanent tax increase in state history, are deeply worrisome.”
Please join US Senator Jon Kyl, Arizona Governor Jan Brewer, and over 45-mayors and city councilmembers from across the state by voting NO on Prop 204 on November 6.

No On<br /><br />
204
We need your help! Please, take your No on Prop 204 yard sign and place it at your polling location the night before the election or the morning of the election.

Lastly, let your family, neighbors, and coworkers know about how Prop 204 actually does very little for education, but fills the pockets of politically connected special interests.

We need to finish strong; we need to defeat Prop 204 and send the message that we want real education reform. Thank you for your continued support!

Thank you,

DonateDoug Ducey
Doug Ducey
Chairman – No New Taxes, No on Prop 204

Proposition 116′s Fate Awaits Election Day

www.VoteYESon116.com

Facebook: Vote YES on 116

Twitter: @VoteYESon116

As the VoteYESon116 campaign heads into the home stretch, small business job creators are optimistic that Arizona’s voters will pass Proposition 116, the Small Business Job Creation Act. The unanimously-passed referendum would create new jobs in Arizona by rolling back the burdensome annual equipment and machinery tax that’s levied before a small business hires its first worker, makes its first sale or even turns a profit. To keep up on developments with the campaign, visit these sites and share them with your family, friends, neighbors and anyone who values your opinion: 

OFFICIAL RESOURCES

VoteYESon116 – visit the official “yes” campaign website to learn more about the referendum

“What’s on My Ballot? – Proposition 116, Arizona’s General Election Guide 2012” – an official publication of the Arizona Secretary of State’s Office

NEWS COVERAGE

“Voters to decide fate of tax exemption for businesses” – newspaper coverage by the Arizona Republic’s Ryan Randazzo

“Proposition 116 supporters say it would spur hiring” – Cronkite News’ Sarah Pringle explains Proposition 116′s impact on job creation

“Prop. 116 supporters: Lower business property taxes would spur hiring” – wire service coverage at KTAR radio’s website from the Associated Press

“Prop 116: Business tax exemption on ballot” – newspaper coverage in the Yuma Sun by Capitol Media Service’s Howard Fischer

NEWSPAPER EDITORIALS

“Our position… Proposition 116: Support”Arizona Republic, October 18, 2012

“Courier: Yes on Proposition 116”Prescott Daily Courier, October 20, 2012 

“Proposition 116 — Yes”Casa Grande Dispatch, October 24, 2012 

“Vote for the good of business”Inside Tucson Business, October 12, 2012

“Proposition 116 would stimulate state economy”Yuma Sun, October 4, 2012

 

VIDEOS

VoteYESon116 “I’ll Hire” Commercial

VoteYESon116 “Cupcake” Commercial

“Vote 2012: Proposition 116” – a 7 minute 23 second video from Eight, Arizona PBS’s Arizona Horizon program on Proposition 116 with NFIB’s Farrell Quinlan

“Arizona Secretary of State Ken Bennett’s 2012 Ballot Measure Town Hall. Proposition 116 – Taxes on Business Equipment & Machinery” – a two-minute video on why voters should pass Proposition 116 featuring NFIB/Arizona’s Farrell Quinlan

“Proposition 116 increases tax exemption for businesses” – a 1 minute 26 second video from Cronkite News reporter Mugo Odigwe features small-business-owner Margie Long of Hot Air Expeditions and NFIB’s Farrell Quinlan on the effects of Proposition 116 on job creation

ORGANIZATIONAL ENDORSEMENTS

Americans For Prosperity – Arizona
American Rental Association – Arizona
AMIGOS (Arizona Mining and Industry Gets Our Support)
Arizona Cattle Feeders’ Association
Arizona Cattle Grower’s Association
Arizona Chamber of Commerce and Industry
Arizona Farm Bureau Federation
Arizona Multihousing Association
Arizona Technology Council
Chandler Chamber of Commerce
Fountain Hills Chamber of Commerce
Goldwater Institute
Greater Phoenix Chamber of Commerce
National Federation of Independent Business – Arizona
Nogales-Santa Cruz County Chamber of Commerce
Printing Industries of Arizona
Tempe Chamber of Commerce
Tucson Hispanic Chamber of Commerce
Tucson Metro Chamber of Commerce
United Dairymen of Arizona
Western Growers

Statement from City of Mesa Mayor Scott Smith on Arizona Proposition 204

Scott Smith

Mesa Mayor Scott Smith

Education has always been a major part of my life. My father, Dr. George N. Smith, was a highly respected teacher and school superintendent here in Arizona for over 35 years. As the superintendent of one of the largest school districts, my father lived education – at the dinner table, at church, even at the grocery store. During his tenure, Mesa’s schools were considered to be among the finest in the nation.

I grew up knowing that quality education was the key to success. That’s why, even as a struggling family, my wife and I made sacrifices so that I could go to law school. That’s also why education has been a key part of my HEAT (Healthcare, Education, Aerospace, Tourism/Technology) initiative in Mesa.

So far, we have had a great deal of success with this initiative. We’ve increased opportunities in higher education by bringing five new colleges to our downtown. We’ve built stronger relationships with ASU Polytechnic, MCC, AT Still and others. We’ve teamed up with Mesa Public Schools to develop a plan to turn underused space into youth sports facilities with the passage of Mesa’s Question 1. I am also pleased to be part of the Mayor’s Roundtable on Education.

I wholeheartedly believe that educating our children is the most important investment we can make in Arizona, and we should expect nothing short of excellence in our educational system. I have seen firsthand how critical quality education is to creating economic opportunities. I have long supported efforts to provide adequate funding for our schools and colleges, expand parental choice, encourage innovation, improve teacher training, and demand accountability.

During this recession, many Arizonans have expressed their displeasure with the manner in which State leaders have handled educational funding priorities. Prop 204 is a product built from this frustration. Unfortunately, it is a flawed product; and, is bad public policy.

Prop 204 imposes a permanent fix for what is most likely a short-term problem. All too often, these inflexible changes become outdated as the world changes. Rather than curing the actual ailment, these solutions end up merely easing the pain for a short time. They then often prohibit substantive reforms that would have a more lasting impact. Prop 204 may even reward the status quo, which will also inhibit real changes in school financing or performance. This will not inspire the kind of transformational reforms that our children need and deserve.

In its attempt to solve one problem, Prop 204 will also simply shift financial challenges from one area of government to another. And, the changes in Prop 204 will make it more difficult, if not impossible to achieve much needed overall state tax reform.

Arizonans should demand real solutions from our leaders to the challenges we face. Prop 204 not only fails to solve these challenges, it will keep us from making the changes we need to improve our educational system. Please join me in voting No on Prop 204. Let’s then work together to make Arizona’s schools the best in America!