GOP walks a fine line on taking federal money for Medicaid; must weigh stigma vs. practicality

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“We’re saying we need to know all the details before committing to taking the federal funds,” Ms. Poe said in an email. “Arkansas seemed to announce what they’re doing and are working out the details on the back end.”

“We were so confused with the speech,” Mr. Fitzhugh said by phone Thursday. “We didn’t know if he turned it down or not.”

Ms. Poe said the governor is not comfortable with a “pure expansion” of Medicaid, especially after Tennessee was forced to reduce its Medicaid rolls by 150,000 people about eight years ago.

Arizona had to freeze Medicaid eligibility for childless adults as an austerity measure in 2011, leading enrollment to drop by 141,000 people, according to Mrs. Brewer’s office.

The governor’s spokesman, Matt Benson, said Arizonans had voted twice — in 1996 and through Proposition 204 in 2000 — to provide Medicaid to people at 100 percent of the federal poverty level or less.

About 240,000 people will come on to Arizona’s Medicaid rolls if it accepts the federal dollars, he said. Among them, only 57,000 would be part of the “expansion” population as opposed to those voters mandated the state to cover.

That, Mr. Benson said, justifies the use of the word “restoration” to describe Mrs. Brewer’s push to accept the federal funds.

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