Brewer also will have to convince the Legislature, whose Republican leaders are leery of the proposal.
"We're not going to just push it out the door," House Speaker Andy Tobin said Wednesday. "She's the executive and she has her plan. But a lot of members have great concern about how this actually rolls out and how it affects the budget."
Brewer plans to pay the state's share — $154 million in the 2015 budget year — by assessing hospitals using the bed tax. The idea is that hospitals that now have millions in uncompensated care will pay the tax and receive much more than that in insurance payments by treating the newly insured. Federal payments that year are estimated at $1.6 billion, or $1.9 billion if childless adults who lost coverage following recent state rule changes are reinstated, according to Brewer's office.
Some hospitals that serve fewer indigent patients have objected to such taxes in the past, but Brewer said she had an unspecified plan to get their backing.
"We understand that there are some hospitals that are not serving that population," Brewer said. "That doesn't mean that they're not on board with what we are doing in regard to the Affordable Care Act."