Choice looms for Ariz governor on health exchange

Associated Press Modified: November 13, 2012 at 12:46 pm •  Published: November 13, 2012

PHOENIX (AP) — Gov. Jan Brewer is being pulled one way by major business groups and another by fellow conservatives as she faces a fast-approaching deadline to decide whether to implement a key part of the federal health care law.

The decision, due Friday, will determine if Arizona creates a state-run, online marketplace for consumers to use when choosing health plans, or lets the federal government create and run a so-called "exchange" for the state.

Brewer is among the Republican governors who oppose the law, but she has yet to indicate what course she'll take.

Down the road, Brewer will face an equally hot-potato decision on whether to expand the state's Medicaid program — another key aspect of the health care law.

Brewer's administration has spent millions of dollars of federal grant money on planning and preliminary work for creating a health exchange.

Republican legislators and conservatives such as the Goldwater Institute say the requirement for an exchange is an infringement on the rights of states and individuals.

Meanwhile, a coalition of business groups wants Brewer to create a state exchange so Arizona has a say in in its design and funding.

"If we retain that control, we're better able to customize and tweak and make adjustments," said Pete Wertheim, a vice president of the Arizona Hospital and Healthcare Association.

Brewer already has selected a minimum benefits package for a state-run exchange based on current insurance coverage for state employees. She noted in a Sept. 28 letter to the Obama administration that the package excludes abortion coverage.

Brewer has said her administration has done a lot of planning to be prepared but also indicated she was still studying the issue and hadn't made a decision.

"I've got to decide (whether) it's the right thing for Arizona," Brewer said while noting she will need legislative approval.

It's clear that establishing a state-run exchange would put Brewer at odds with many Republicans in the Legislature, with no assurance that she would win the necessary approval.

"I don't believe there are the votes in the House to pass something like this, so I don't think this is going to go anywhere," said House Appropriations Chairman John Kavanagh, a critic of the health care law and its penalties on some employers who don't provide coverage to workers.

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