The Supreme Court's decision to uphold most of the Affordable Care Act but strike the requirement that states expand their Medicaid coverage affects state governments.
That leaves Arizona lawmakers trying to figure out what's next.
State lawmakers set aside money in next year’s budget to make sure there was enough to cover the Affordable Care Act’s requirement that states offer Medicaid to more people.
Arizona’s Medicaid program is called AHCCCS and in all states Medicaid is offered only to the poorest residents.
Republican lawmakers here say it’s good Arizona won’t have to expand that program immediately.
But State Rep. Ted Vogt, R-Tucson, says the decision leaves some gray areas for state lawmakers on how much flexibility they have in providing Medicaid coverage.
“The Supreme Court said the federal government can't do that but it didn't draw the line and really mark out well where is that line of where Congress overstepped its bounds, so while I think that part of the ruling is good, it's an unanswered question,” he says.
He thinks that unanswered question will require a legal opinion to resolve.
State Rep. Anna Tovar, D-Tolleson, points out that the state can still expand its Medicaid coverage and receive some funding for that from the federal government.
“In my view, if the governor does not accept those funds, that’s definitely a step in the wrong direction for the people that need it the most," she says.
Even if Gov. Jan Brewer and state lawmakers don’t expand Medicaid to cover as many people as the Affordable Care Act was designed to include, Tovar says the court’s decision to uphold most of the health care law will still help Arizonans.
“Citizens of Arizona will still be covered and they will still get a subsidy on the exchange system,” she says, meaning the system in which the poorest residents who aren’t covered by their state’s Medicaid program can sign up to get health insurance and receive a tax credit or subsidy directly from the federal government to make it more affordable.
The nuances of the Supreme Court’s nearly 200-page ruling are many, and Vogt says it will take some time to figure out what it all means for Arizona.
”It’s really probably too early to speculate on how much the sate is going to have to do and how quickly we’re going to have to do it to comply with some of the deadlines the national, the federal health care puts on us," he says.