In case you missed it, the Arizona Executive and Legislative branches are embroiled in a battle over expanding Obamacare’s Medicaid program in Arizona. Here is the latest Friday poll gauging our reader’s position on this issue. Votes are scheduled in the Arizona House next week.
Friday Poll: Do You Support/Oppose Obamacare’s Medicaid Expansion in Arizona?
Arizona Conservative Coalition Updated Ratings
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For detailed evaluation data, click on detail evaluation data.
For Frequently Asked Questions, click on FAQs.
Medicaid Expansion: Been There, Done That

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 week, the 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
AZ Conservative Coalition Updated Legislator Ratings
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For Frequently Asked Questions, click on FAQs.
Jeff Weninger Launches Exploratory Committee for State Office Run
Chandler City Councilman Jeff Weninger today filed the necessary paperwork with the Secretary of State to form an exploratory committee for the Arizona House of Representatives in Legislative District 17.
Weninger is serving his second term on Chandler Council and previously served as Vice Mayor. He also currently holds a Republican Precinct Committeeman seat in District 17. In addition, Weninger has run five successful valley restaurants as co-owner for the last 17 years.
Weninger’s decision to form an exploratory committee is largely due to the numerous requests he has received from Republican leaders within the state, including Representatives J.D. Mesnard and Tom Forese, and Senator Steve Yarbrough, who currently represent the district. Jeff has the support of all three legislators.
Representative J.D. Mesnard said, “Jeff has long demonstrated his commitment to our community in his professional endeavors and through his service on the Chandler Council. He has the right principles and I’m excited about the chance to serve with him in the House.”
“I am thrilled at the prospect of Jeff filling my seat in the Legislature as I look at pursuing other opportunities,” said Representative Tom Forese. “In addition to being a husband, father, business owner, and public servant, Jeff is a proven leader.”
Senator Steve Yarbrough emphasized that Jeff has been a strong conservative voice ably representing the values of East Valley residents as both a family man and a businessman. “He will be a great addition to the state House of Representatives,” Yarbrough said.
“I am honored to have the support of so many respected Republican leaders, particularly those who have been faithfully serving this district,” Weninger stated. “I am looking forward to hearing from the citizens in District 17 as my family and I explore this important decision on running for the State House.”
Jeff is a life-long Republican and has lived in the East Valley for 20 years. He and his wife Janet have three children and reside in Chandler.
Update on Obamacare-Medicaid Expansion in Arizona
Here’s a brief update on the push to expand Medicaid in the Arizona Legislature.
Rumors are circulating that Senator John McComish is attempting to orchestrate a coup d’état on Senate President Andy Biggs as former Senate President Steve Pierce looks on with plausible deniability. Why a coup? Because Senate President Andy Biggs is the one individual holding firm against a vote on Obamacare’s Medicaid expansion in the State Senate. Both McComish and Pierce are supporting Governor Brewer and trying to pave the way for her Medicaid plan. But you should also know that McComish and especially Pierce took thousands of dollars from higher-ups in the healthcare industrial complex during the last election cycle. (Biggs did not.) We are compiling the names and amounts of all the donations received by Medicaid proponents with the goal of connecting the dots. Just another example of the corporate-political incest (yes, it happens on both sides.)
Meanwhile in the State House, Governor Brewer does NOT have the votes to pass her Medicaid expansion. Proponents of Medicaid expansion are short the votes needed to require both a simple majority and two-thirds vote (Prop 108 requirement). House Speaker Andy Tobin is also holding back a vote on the legislation so you can imagine he is under tremendous pressure to let the legislation move for a vote.
At the same time all this is taking place, Democrats are getting very irritated with an effort to amend any legislation to prohibit our tax dollars from going to Planned Parenthood. (We all know that giving money to Planned Parenthood is an accounting game that allows them to free up other funds for abortions.) Democrats want the Medicaid bill to remain silent on tax dollars to abortion providers because they know Planned Parenthood would be feasting off the same steady stream of tax dollars “returning” from the federal government. In fact, House minority leader and likely Democrat gubernatorial candidate Chad Campbell sent an email out today expressing frustration, covering for abortion providers and urging individuals to call their legislators. His rhetoric has heated up calling social and religious conservatives “extremists,” “right-wing” and “special interests” all because they oppose using tax dollars to fund Planned Parenthood.
Keep your eyes on the players in this whole exercise of corporate cronyism and who stands to gain the most “free” tax dollars.
APS Continues Pressure to Quash Solar Energy Choice in Arizona
Several weeks ago when I took up the cause of energy choice via the issue of net metering, little did I realize I would strike at the nerve of the big utility energy monopolies like APS. While my intention was not to overly criticize the Republican-led Arizona Corporation Commission, several of my posts were mistakenly perceived that way when all along criticism, was meant to challenge big utilities for quashing energy choice.
Recently, Arizona Public Service Co.’s CEO Don Brandt wrote an editorial in defense of APS’ push to eliminate net metering claiming that rooftop solar consumers are a burden on other energy consumers not using solar. What’s striking in this is the audacity of APS’ top executive blaming solar users while APS pushes to widen its profit margin. The last time I checked, APS was regulated by the ACC because of its unique monopoly power in the marketplace. Thanks to the commissioners at the ACC, APS has been kept in check.
I’ve obviously struck a nerve with APS (as other utilities watch this critical discussion take place) to the point where the CEO feels the need to respond and wage a public relations battle against those who want the choice to offer back a surplus of clean, cheap energy. APS obviously feels threatened – and they should – after recent polls show energy choice is extremely important to Arizonans.
It’s time for credit and criticism to be given.
To the Arizona Corporation Commissioners I commend them for a job well done in holding the line for ratepayers, encouraging energy innovation and for the pursuit of realistic consumer-based energy choices for Arizonans. I also continue to urge and encourage the ACC to reject the pressures by big utilities like APS prowling for corporate cronyism deals.
Thanks to the Arizona Corporation Commission, solar is a great success story in our state and will be operating free of utility incentives by the end of the year. With Arizona continuing to score solar touchdowns for schools, consumers and thousands of solar jobs let’s not fumble in the red zone because APS is trying to strip the ball away.
Weekly Update – 4/26/13 – of AZ Conservative Coalition Legislator Eval
Updated Ratings!!!
Arizona Conservative Coalition Republican Legislator Rankings
Legislative Actions as of 4/26/2013
Last Updated 4/28/2013
Narrative:
The number of bills being tracked is 254 plus 3 Strike All amended bills.
There were some bills voted on this week that increased economic regulations or expanded the delegation of law making (regulatory) authority from the legislature to the executive branch. There were votes to add regulatory requirements to insurance agents, add state regulation of Music Therapists, and burden private providers of Department of Motor Vehicle Services with regulations that it is likely the actual Department of Motor Vehicles is unable to comply with (the private companies can be shut down, though, while the government agency cannot be). Some Republican legislators voted against these laws, but many voted in favor of them (along with most Democrats).
We have added a new feature to the ratings. There is now a section showing scoring exceptions for a legislator voting NO on a bill in order to make a motion to reconsider it. This is explained in the score section in more detail. The basic idea is that, in this special case, a NO vote is counted as a YES vote in the evaluation because the legislator is actually advancing the bill by using the NO vote as a parliamentary tactic to be permitted to give the bill another chance to be voted on.
As we near the end of the session, we remind legislators as well as the voters to beware of omnibus bills and last minute amendments that can contain legislative language that might be glossed over by overwhelming legislators with too many pages of legislation to read before voting or by making last minute changes that are difficult to properly evaluate before a vote. Legislators should understand that any bill containing legislative language from a bill that we gave a negative weight may get the negative weight of that negatively weighted bill regardless of how many good things are also in the revised bill currently being voted on. Since it will be impossible for the contents of omnibus bills or bills with last minute amendments to be known early enough for an announcement about how the bill weights will be reset for the evaluation, everyone needs to be aware that they will be evaluated on the final version of the bills they vote on after the votes take place. With the Governor digging in to pressure the legislature to expand Medicaid, we will be watching for that in late breaking bills as well as appropriation omnibus bills. We will also be looking for Common Core funding in omnibus bills. We strongly oppose both and will weight bills that include them accordingly.
These are NOT final scores for the session until our final report after the session ends! We encourage conservative activists to use these weekly evaluations as a way to work with legislators to achieve more conservative results in the legislative session.
The legislation causing the most lowering of scores is HB2047 combined with HB2045 which switches Arizona from the AIMS standard to the Common Core standard. Our concern is that Common Core surrenders state autonomy on education to the federal government and promotes nationalization of education well beyond the proper scope of the federal government. In addition, the curriculum associated with Common Core relies on an international perspective instead of traditional study of American and World history. HB2425 was passed by the legislature and signed by the Governor.
Other bills having a significant negative impact on scores remove significant limitations on school district spending, allow executive agencies to set fees in order to bypass limitations on the legislature raising taxes or fees, or increase government regulation of businesses.
Many Republican legislators have argued that good business regulations that “make people do the right thing” are good. This, unfortunately, is almost a perfect definition of fascism which Republicans traditionally oppose. There are always situations where we might wish others would deal with us on terms of our choosing when they are not willing to do so. Using government to force people to deal with us on our terms rather than mutually agreed upon terms is tyranny even if it is dressed up as consumer protection or professional responsibility or trying to improve market efficiency. Of course, in a free economy, people can decide for themselves what is good and make decisions on that basis as both consumers and businesses. Also, government regulations usually have unintended consequences that are usually bad. These consequences are then used to justify still more regulation when less regulation is the best solution.
For detailed evaluation data, click on detail evaluation data.
For Frequently Asked Questions, click on FAQs.
Weekly AZ Conservative Coalition Legislator Eval Update
Updated Ratings!!!
For Frequently Asked Questions, click on FAQs.
Arizona Stands for Health Care Freedom!
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Updated AZ Conservative Coalition Legislator Ratings
Updated Ratings!!!
Arizona Conservative Coalition Republican Legislator Rankings
Legislative Actions as of 4/12/2013 Last Updated 4/16/2013
Narrative:
Two bills were added to the evaluation after being brought to our attention by members of the legislature. Although it is late in the session, both bills are well within our policy guidelines indicating the type of weight they would receive.
HB2341 reduces government regulation on remodeling homes when significant structural changes are not being made. We weighted this (+5) because it actually rolls back government regulation. If it had been brought to our attention earlier in the session, it would have gotten a higher weight because the information would have been available before the votes. However, reducing regulations on citizens is a consistent policy objective we espouse.
SB1223 eliminates Fish and Wildlife fees being set by the legislature and assigns that responsibility to an unelected board. This is an obvious attempt to bypass rules that require the legislature to get two thirds majorities to raise taxes and fees. We have consistently told legislators we would weight any bills that delegate the legislature’s taxing authority to the executive branch of government as (-10). That is the weight assigned to SB1223.
The weight on SB1437, a bill for establishing licensing for music therapists, was changed from (-6) to (-5) because an amendment adopted in the House slightly improved the bill by addressing one of our concerns. The weight of (-5) still indicates we oppose the bill as we cannot see that it is an appropriate role for the government to help certain groups of professionals and/or businesses either form cartels, restrict competition, or use the government to provide them with a seal of approval or respectability.
The number of bills being tracked is now 254 plus 3 Strike All amended bills. There were some changes in scores – especially a general move downward in the Senate.
These are NOT final scores for the session until our final report after the session ends!
We encourage conservative activists to use these weekly evaluations as a way to work with legislators to achieve more conservative results in the legislative session.
The legislation causing the most lowering of scores is HB2047 combined with HB2045 which switches Arizona from the AIMS standard to the Common Core standard. Our concern is that Common Core surrenders state autonomy on education to the federal government and promotes nationalization of education well beyond the proper scope of the federal government. In addition, the curriculum associated with Common Core relies on an international perspective instead of traditional study of American and World history. HB2425 was passed by the legislature and signed by the Governor.
Other bills having a significant negative impact on scores remove significant limitations on school district spending or increase government regulation of businesses. Many Republican legislators have argued that good business regulations that “make people do the right thing” are good. This, unfortunately, is almost a perfect definition of fascism which Republicans traditionally oppose. There are always situations where we might wish others would deal with us on terms of our choosing when they are not willing to do so. Using government to force people to deal with us on our terms rather than mutually agreed upon terms is tyranny even if it is dressed up as consumer protection or professional responsibility or trying to improve market efficiency. Of course, in a free economy, people can decide for themselves what is good and make decisions on that basis as both consumers and businesses. Also, government regulations usually have unintended consequences that are usually bad. These consequences are then used to justify still more regulation when less regulation is the best solution.
To look at the AZ Conservative Coalition home page, click on Home Page.
To look at the legislator scores, click on legislative report.
For bills used in evaluation, click on bill weights.
For Frequently Asked Questions, click on FAQs.
Uninsured May Have Better Access to Care than Medicaid Patients, Survey Shows
The public relations campaign to support Medicaid expansion frequently uses testimony by patients with serious medical conditions who have lost their private insurance. It is assumed that once they qualify for Medicaid, they will easily get their chemotherapy, hepatitis c treatment, or defibrillator battery replacement.
“The messages talk only about coverage, not care,” states Jane Orient, M.D., executive director of the Association of American Physicians and Surgeons (AAPS). “But the real question is whether Medicaid provides access to care.”
An internet survey of AAPS members shows that about 47% of respondents think that it is more difficult for a Medicaid patient, compared with an uninsured patient, to get an appointment with a primary-care physician. Only 26% thought that the uninsured had more difficulty. For specialist appointments, 44% thought uninsured patients were better off, and 32% thought Medicaid patients were better off. Only 2% thought that Medicaid patients had “no problem” getting an appointment with a specialist.
When asked, “How easy is it for a Medicaid beneficiary to obtain drugs, medical equipment, or diagnostic tests?”, 48% said it could be “extremely difficult,” 27% said “moderately difficult at times,” and only 13% said it was “no problem.”
Of 166 respondents, 96 were physician specialists, 63 primary physicians, and 7 emergency physicians.
Open-ended comments were overwhelmingly negative about Medicaid. Rural patients who are unable to drive or travel may have no access to care at all except through charity. Some areas have no hand surgeons, endocrinologists, dentists, or rheumatologists who will accept Medicaid. Many cardiology tests, even echocardiograms on inpatients, are questioned or denied. Many drugs, even common generics, are unavailable without jumping through bureaucratic hoops. Treatment for chronic pain is especially difficult. It may be very challenging to get non-emergency surgery approved, no matter how necessary.
“Medicaid ends up as a jobs program for administrators and quasi-medical professionals,” writes one physician. “Very little of Medicaid money actually goes to the ‘health care’ part of the equation.” Another said that “poor customer service is the norm” and “excessive paperwork is routine.”
Because it may cost more to file a claim than a physician can hope to collect, physicians may lose on every Medicaid patient, and lose less if they just see the patients for free.
Stating that “denials were much more common than approvals for appropriate treatment options and diagnostic studies,” one physician concluded that “to expand such a horrendous program is insane.”
AAPS, which was founded in 1943, is a national organization representing physicians in all specialties.
Dr. Kelli Ward: Opposition to Medicaid Expansion is Real
Since January, many of us at the State Capitol have been trying to determine a common sense way to approach reliable health care for our neediest citizens. It is clear that a full expansion of our Medicaid program to 138% above the Federal Poverty Level (FPL) will add 400,000 patients or more to an already overloaded system. After carefully studying this complex issue, I have determined the plan is unsustainable and potentially harmful to hardworking Arizona taxpayers. We simply do not have the doctors and other health care providers to offer primary care to these new patients. When people are sick or seek care for their chronic illnesses, they will not be able to get into a doctor’s office, so they will instead turn to our emergency departments. Not only will that be much more expensive to Arizonans, but the people are unlikely to get the kind of care they need most.
The last time we expanded AHCCCS (the Arizona Health Care Cost Containment System – AZ’s Medicaid); we grossly underestimated the number of people who would enroll. Three times more parents of Medicaid-covered children and two times as many childless adults signed up. Costs went from an estimated $315 million to an actual $1.2 billion. Voters were told tobacco settlement money under Prop 204 would cover the added patients, but quickly we had to dig into the general fund. Now we are being told a hospital bed tax will cover this expansion proposal and the Federal government will bear the burden of the majority of the costs until 2017. Remember, the Federal government gets its money from us – the taxpayers. While no one can predict the true future price tag, experience proves that the costs have always been much higher than estimated.
Do not let people tell you there are no alternatives and we either expand or do nothing – there are real options. We should request that HHS allow Arizona to continue our current plan for those under 100% FPL and for Arizona to determine the best way to provide care for our indigent population. We should find ways to complete treatment of Medicaid patients that are in the midst of potentially lifesaving therapy for catastrophic illnesses despite the expiration of our current Federal waiver on December 31, 2013 – we can find a way to make an exception for this small number of patients. People above 100% FPL that are not otherwise eligible for coverage are able to buy subsidized policies through the federal exchange, we should let them. We should consider providing catastrophic coverage policies for those under 100% of the Federal Poverty Level and a graduated plan for other services. Cost transparency should be our goal. We must seek tort reform to discourage the practice of defensive medicine which drives up the cost of healthcare.
Our Medicaid system in Arizona is one of the best in the country, but I don’t believe that we need to make it bigger and give control of the hundreds of millions of dollars to an unelected agency director. I will continue to seek free market solutions to our health care dilemma and find ways to care for those who are unable to care for themselves. If you only remember one thing, remember this: the Medicaid expansion plan is about increasing the entitlement to healthcare coverage without any guarantees of increased accountability, improved access to care, higher quality, or lower costs of healthcare – it is a step in the direction of socialized medicine and much bigger government.
Senator Kelli Ward
Senator Kelli Ward, D.O., MPH is a Family Physician with additional expertise in Health Policy, she represents Arizona’s 5th Legislative District and resides in Lake Havasu City, AZ with her family. She serves on the Senate Health & Human Services (Vice-Chair), Appropriations, Education and Government & Environment Committees.






