Arizona's Gov. Jan Brewer

Yesterday, Arizona Gov. Jan Brewer endorsed taking advantage of the Affordable Care Act to expand Medicaid to everyone up to 138% of the federal poverty level. While Brewer has been one of the most vocal opponents of “Obamacare,” in her State of the State address she acknowledged that it is the law of the land and must be dealt with as such. From her prepared remarks:

Saying ‘no’ to this plan would not save these federal dollars from being spent or direct them to deficit reduction.

No, Arizona’s tax dollars would simply be passed to another state – generating jobs and providing health care for citizens in California, Colorado, Nevada, New Mexico or any other expansion state.

Remember: Arizona citizens have voted TWICE to expand Medicaid coverage.

With this move, we will secure a federal revenue stream to cover the costs of the uninsured who already show up in our doctor’s offices and emergency rooms.

Brewer joins Gov. Susana Martinez (R) of New Mexico and Gov. Brian Sandoval (R) of Nevada as part of the small group of Republican governor to have endorsed expanding Medicaid. So far most Republican governor who have taken a position have come out against expansion with 10 governors having stated that they plan to rejected it for at least the time being.

Brewer also made a point of saying she will “not allow Obamacare to become a bait-and-switch.” If the federal funding is cut she plans to have the expansion automatically rolled back. This highlights how the Supreme Court decision making Medicaid optional has indirectly taken it off the table in potential budget negotiations. If Obama wants his signature law to be mostly implement he has to keep the expansion a very good deal for the states.

Photo by Gage Skidmore under Creative Commons license