Appeals court skeptical of Medicaid expansion law challenge

February 14, 2017 GMT

PHOENIX (AP) — An Arizona Court of Appeals panel appeared skeptical Tuesday of arguments raised by challengers to a fee supporting the state’s costs for expanding Medicaid coverage, sharply questioning the lawyer trying to strike down the funding mechanism in one of former Gov. Jan Brewer’s signature achievements.

The three judges honed in on the arguments made by Christina Sandefur, who represents Republican lawmakers who sued to try to overturn the hospital assessment approved by a majority of state lawmakers in 2013. Sandefur, a Goldwater Institute attorney, told the judges that the hospital assessment required a two-thirds majority to pass and an exception in a 1992 Constitutional amendment known as Proposition 108 rarely if ever applies.

Judge Paul J McMurdie got nods from the other two judges Tuesday when he said Sandefur’s argument appeared illogical.


“You wouldn’t need the exception if they did it by a supermajority,” McMurdie said. “That is the most circular argument I think I’ve ever heard.”

Brewer, a conservative Republican, pushed Medicaid expansion through the Legislature in 2013 and it has since added about 400,000 people to the program. She was in court and said she’s proud of the achievement.

“I don’t regret today anything that I did in regards to this,” Brewer said. “I think it was right thing to do, it saved lives, it insured more people, it brought money into the state, it kept rural hospitals from being closed down. And today there are tens of thousands of people that are very, very grateful.”

The measure was one of the most contentious of the 2013 legislative session and passed after a handful of Republicans joined all Democrats in voting to expand the program. Medicaid expansion is a key part of President Barack Obama’s health care overhaul law, the Affordable Care Act. The law restored coverage for childless adults earning less than 100 percent of the federal poverty level who had previously been covered in Arizona, and extended coverage to all Arizonans legally in the country who earn up to 138 percent of the poverty level.

Brewer surprised many when she embraced the expansion, and angered many other Republicans with her efforts, which included calling a special session after Republican legislative leaders stalled a vote on the measure for weeks.

The hospital assessment has been the focus of a lawsuit ever since. The state Supreme Court allowed the case to proceed, and a trial court judge in August 2015 decided that it was not a tax and didn’t require a supermajority.

The lawmakers represented by Sandefur appealed.


In contrast to the sharp questioning of her by all three judges on the panel Tuesday, the attorney defending the case for the state, Douglas Northup, was left answering questions about his opponent’s argument.

He said a lower court judge had gotten it right when he ruled that the exception for the two-thirds vote applied to the hospital assessment.

The appeals court took the case under advisement and will issue a written ruling later.