Challengers to Medicaid expansion might lack necessary signatures - East Valley Tribune: Health

Challengers to Medicaid expansion might lack necessary signatures

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Posted: Monday, September 9, 2013 5:00 pm | Updated: 6:50 pm, Tue Sep 10, 2013.

PHOENIX — Organizers of a bid to block Medicaid expansion in Arizona conceded they may not have the necessary signatures on petitions to force the issue to the ballot.

“We're over 70,000,” former state Sen. Frank Antenori told Capitol Media Services on Monday.

Ron Gould, another former state senator involved in the effort, said there are last-minute efforts to gather up the petitions that have not yet been turned in.

“So it's going to be close,” Antenori said.

But Antenori said it's not simply a question of getting the 86,405 signatures legally required to hold up enactment of the plan approved by the Legislature until voters can weigh in at the next election. He acknowledged it's not unusual for a third or more of signatures on petitions to be declared invalid for various reasons, such as a person not registered to vote.

“It's probably going to be tough to ward off a decent challenge,” Antenori said.

Meanwhile, a separate referendum challenging various changes in election laws approved by the Republican-controlled Legislature appears on track to qualify. That group has scheduled a press conference for Wednesday afternoon to turn in its signatures.

“We know we're over 100,000,” said Julie Erfle who is chairing that effort. “That's all we're saying right now.”

But Erfle said she is “very, very confident we'll be on the ballot.”

Money appears to be a key difference.

The bid to force a public vote on the election law changes was fueled by donations of more than $300,000, enabling it to gather the signatures it needed.

By contrast, the Medicaid expansion measure had been premised on using a network of volunteers, drawn from the ranks of Republican Party workers, to get the signatures. It was not until late last month that the organization got its first — and only — large donation: $20,000 from the Tea Party Patriots.

At the same time, backers of Medicaid expansion raised more than $350,000 from business interests and hospitals to block the referendum. Their tactics included hiring people to circulate their own petitions promoting a larger Medicaid program even though those petition have no legal force or effect.

Antenori said that maneuver left his group few people available to circulate referendum petitions even after he got some money.

The fight is over a measure pushed through the Legislature by Gov. Jan Brewer to impose what amounts to a tax on hospitals to bring 300,000 or more into the Arizona Health Care Cost Containment System.

Arizona currently provides care for most individuals below the federal poverty level, about $19,530 a year for a family of three. That amounts to about 1.3 million residents, with the federal government picking up about two-thirds of the cost.

Several years ago, though, the state stopped enrolling single adults in the program even if they were otherwise qualified.

Since that time Congress has approved the Affordable Care Act. It provides generous federal subsidies to states that expand coverage to 138 percent of the poverty level.

The legislation expands eligibility and restores coverage for the single adults who have been shut out of the program using those hospital taxes. The hospitals went along after being shown figures by the Brewer administration that they would gain more cash than the tax paid by having more patients with insurance and fewer unable to pay their bills.

Foes contend the federal dollars are unsustainable, saying the state will be stuck with the entire burden when Washington defaults.

The measure does have a “circuit breaker” scaling back the program if federal funding drops below 80 percent of the cost. But opponents say that is insufficient to protect against political pressure to maintain coverage.

Others opposed to the law have different concerns, including some who have labeled the whole federal program “socialized medicine.”

Even if the referendum fails, another hurdle awaits.

A provision of the Arizona Constitution requires that any increase in taxes or revenues to the state must be approved by at least a two-thirds vote of both the House and Senate.

The expansion plan did not get that margin, but supporters and Gov. Brewer contend the levy on hospitals is simply an “assessment” crafted by AHCCCS and not a tax.

That is virtually certain to be challenged in court.

Getting that legal issue resolved is crucial: The expanded program is supposed to kick in on Jan. 1.

A third referendum designed to kill a plan to increase in school bonding capacity already has fallen by the wayside. Organizer Wes Harris said he was relying on the same volunteer circulators carrying the Medicaid referendum petitions.

“It's kind of hard to get people to sign two things,” he said.

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