All Arizona’s Democrats supported the biggest expansion of health coverage since Medicare and all Republicans opposed it, reflecting the bigger partisan divisions revealed by the historic vote.
First District Congresswoman Ann Kirkpatrick hesitated, but backed the measure that requires all Americans to buy health insurance and provides subsidies that will provide coverage to an estimated 31 million people now uninsured — including 118,000 First Congressional District residents.
Studies suggest that up to 45,000 people die annually due to a lack of insurance.
“I am putting my district first by voting for this reform package,” said Kirkpatrick, a freshman congresswoman in a swing district who will likely face a tough tough re-election fight.
“Health insurance reform is critical to ending denials of coverage based on pre-existing conditions, making sure our children can get the care they need and protecting seniors from unaffordable prescription drug costs,” she said.
Arizona Gov. Jan Brewer had a different view of the vote. “Yesterday, the Democrats in the United States Congress approved a more than 2,000-page health care bill that is financially devastating to the state of Arizona, as well as many other states across the nation. Despite my opposition and the opposition of a vast majority of Arizonans, and although it is clear that the costs of these programs are completely unsustainable, every single Arizona Democrat in Congress voted for this bill and its massive costs to our state budget. They are personally and directly responsible for growing our state budget deficit.
“This federal bill is not even 24 hours old, and yet some of Arizona’s legislative Democrats are already proposing a tax increase to pay for its increased costs.
“As passed by the U.S. House of Representatives, this more than $1 trillion federal government takeover of health care is paid for on the backs of state governments. With its back-room loopholes, it will cost the citizens of the state of Arizona at least $1 billion in 2012 and more than $1 billion in 2013. No one knows yet, with certainty, what the cost will be to Arizona’s taxpayers in this current fiscal year 2011 budget because the true costs of this federal bill have been hidden away in other pieces of federal legislation that have not yet been approved.
“The state deficit hole they have created could be over $400 million in fiscal year 2011. In fact, this bill does not provide enhanced federal funding for KidsCare until 2014, nor does it provide enhanced federal funding for the Proposition 204 AHCCCS population until 2014. It provides new mandates immediately, and just the hope that Congress will have money to pay for them in three years.
“I will continue to coordinate and vigorously pursue with other leaders from across the U.S. any and all legal remedies to prevent this massive new entitlement from enactment and to protect our children and our families from relentless federal intrusion into their lives,” Brewer said.
Sen. John McCain, seeking re-election and facing a primary challenge from former Rep. J.D. Hayworth, also blasted the bill, which drew not a single Republican vote.
“I still think this is terribly wrong for America and Americans. With all the euphoria going on inside the beltway, champagne toasting and all of that, outside the beltway people are very angry. And they don’t like this. And we are going to repeal this. And we are going to have a very spirited campaign coming up between now and November. And there will be a very heavy price to pay for it,” McCain said.
The potential expansion of insurance coverage begins in 2014.
The latest state budget bill will shut down the mostly federally funded Children’s Health Insurance Program, which will take coverage away from 47,000 low-income children. Cuts in the AHCCCS program will cost another 310,000 low and moderate income Arizonans state insurance coverage, about three-quarters of which is paid for by the federal government.
The Commerce Committee provided an estimate of the impact of the bill on each Congressional District. Projected impacts in the First Congressional District, which includes Rim Country, Flagstaff, the Navajo Reservation and a great swath or rural Arizona all the way down to Gila Bend, include:
• Extend coverage to 118,000 people without insurance.
• Allow 66,000 young adults to get coverage through their parents.
• Provide funding for 30 community health centers.
• Reduce uncompensated care for local hospitals by $54 million.
• Provide broader coverage for 331,000 residents.
• Reduce prescription drug costs for 127,000 Medicare recipients.
• Provide help paying insurance premiums to 203,000 families and 14,800 small businesses.
• Provide coverage for an estimated 20,000 people denied coverage as a result of pre-existing conditions.
The study released by the Democratic controlled Congressional Committee on Energy and Commerce estimated that 45 percent of the 331,000 residents in the district get coverage either through employers or private insurance.
The reforms would not necessarily affect existing coverage, but would require all insurance plans to eliminate lifetime limits on coverage, prevent plans from dropping people if they get ill or deny coverage for pre-existing conditions and limit insurance company spending on administration, profits and overhead.
The changes would set up a national insurance exchange for people seeking coverage and provide tax credits to reduce the cost of coverage for families with incomes up to $88,000. A family of four with an income of $50,000 could in theory qualify for a $5,800 tax credit to cover the cost of medical insurance.
The study estimated that 203,000 households in the First Congressional District could qualify for the subsidies.
The sweeping federal reform of health insurance would impose some changes immediately, but the most sweeping measure would not take effect for several years, including a requirement that all Americans buy insurance and expanded requirements for businesses to offer insurance coverage for employees.
The plan would provide subsidies to lower the cost of that required insurance for low and moderate income Americans and for small businesses. Businesses with fewer than 50 workers would not have to provide insurance.
Kirkpatrick voted for the even broader House version of the bill, but had declined until days before the vote to say which way she planned to vote on Sunday’s measure, in which the House essentially adopted an earlier Senate version with only minor changes.
Kirkpatrick, with one of the most conservative voting records among House Democrats, nonetheless provided one of the key votes for the measure.
“I was able to make important improvements to this bill, including addressing the potential costs for AHCCCS and eliminate politics-as-usual special deals like the Cornhusker Kickback.
McCain, appearing on ABC’s Good Morning America, bitterly opposed the health care reforms Kirkpatrick supported.
McCain said he favored some of the items in the bill, but overall “they’re going to bankrupt the country. We want to start over. We can address those issues. The American people, by a 2-1 margin, want us to start over.
“For the first time in history, we have a major reform enacted, without a bipartisan support for doing so. In fact, a two-thirds majority saying they don’t like it. So I believe the will of the people is reflected, sooner or later, in the makeup of the government. And when you go against the will of the people, you pay a price.”
A CNN poll taken days before the vote showed 39 percent of registered voters favored the measure and 59 percent opposed it. However, 13 percent of the opponents said they opposed the bill because it wasn’t “liberal” enough.