Arizona's Republican Governor Jan Brewer signed a law on Monday to expand Medicaid, embracing a key part of Democratic President Barack Obama's healthcare plan in a hard-won policy victory over conservatives in her own party.
Brewer, a feisty opponent of the Obama administration over immigration enforcement, signed a bill that will make about 300,000 additional poor and disabled residents eligible for the Medicaid program, a move opposed by some conservative Republican lawmakers.
With the signing, Arizona became the 24th state to move ahead with the expansion, according to the Kaiser Family Foundation, a California-based nonprofit that tracks the issue.
Brewer, who outmaneuvered opponents by forming a bi-partisan coalition of legislators, said the $1.6 billion expansion drawing on federal funds under the Affordable Health Care Act was the right move for the state.
"I knew I had not chosen the easy path. But I learned a long time ago that what is easy and what is right are rarely the same. Well, today I know in my heart that we have made the right choice," said Brewer, surrounded by lawmakers at a signing ceremony at the state Capitol in Phoenix.
Opponents said the decision to take up a key part of the federal reforms they call "Obamacare," could be costly for the state should the federal funding run dry. They dubbed the plan "Obrewercare" during legislative debate.
The Medicaid expansion was Brewer's top policy goal. For five months she pushed its passage with rallies across the state and the backing of a group of business and health care groups.
Brewer called the legislature into special session last week, armed with the votes of key moderate Republican lawmakers. Both houses, which are controlled by Republicans, passed the measure with comfortable margins on Thursday.
In addition to expanding services, Brewer said the move would protect rural and other hospitals from the rising costs of paying for uninsured patients, inject $2 billion into the state's economy and create thousands of jobs.
As part of the plan, Brewer said there would be a "circuit breaker" to call an automatic halt to the expansion if the federal reimbursements decrease.
Under the Affordable Care Act, the federal government agreed to increase Medicaid eligibility and cover 100 percent of the costs for three years, after which it will cover 90 percent.
Last June, the U.S. Supreme Court upheld Obama's healthcare overhaul, but allowed states to opt out of a provision expanding the Medicaid program.
Brewer first became widely known as an Obama administration critic in 2010 when she signed Arizona's tough crackdown on illegal immigration, allowing police to question those they stopped and suspected were in the country illegally about their immigration status. The law was upheld by the U.S. Supreme Court.
She drew nationwide attention when she wagged her finger at Obama during an encounter at an airport tarmac in Phoenix.
On Monday, she thanked coalition lawmakers for mustering the courage to pass the legislation.
"You put people before politics and you stayed strong in the face of personal attacks," she said.