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EXPANDING AHCCCS

One of the biggest decisions facing state lawmakers is whether to expand the state's AHCCCS rolls to include people who earn up to 133 percent of the federal poverty level.

It's a key element of the Affordable Care Act's effort to get low-income Americans covered by health insurance. As the bill was originally written, states had no choice but to opt in to the expansion, because they'd lose all their federal Medicaid dollars if they did not.

But the U.S. Supreme Court ruled that requiring the states to expand the Medicaid program was too coercive, so states can decide whether to participate.

There's a considerable financial incentive attached in the form of hundreds of millions of federal dollars available to pay for the program.

This week, Secretary of Health and Human Services Kathleen Sebelius wrote to state governors to tell them that it's an all-or-nothing deal: If they want the federal dollars, they must expand all the way to 133 percent of the federal poverty level.

In Arizona, the Joint Legislative Budget Committee staff projected that the state would have to pony up about a billion dollars between now and 2020, but would receive about $14.7 billion in matching federal funds.

That's a darn good return on investment. It ensures that the poorest of Arizona residents get health-care coverage. The state's hospitals and clinics are no longer seeing a lot of unbilled patients jamming up emergency rooms, because they have no other options for health care.

Nonetheless, we get a sense that the conservative Republicans who run the state aren't going to embrace the opportunity, for a number of reasons: They hate the idea of supporting Obamacare in any fashion; they have a philosophical opposition to government spending in general; and they fear that the federal government will not continue to provide the matching funds in the future.

Or, as outgoing state Sen. Frank Antenori put it last week: There's "not a snowball's chance in hell" that the expansion is going to happen.

While lawmakers are likely to balk, there's a chance that Arizona citizens might be able to make it happen through the initiative process.

In order to do that, though, initiative-backers will have to find a funding mechanism that could bring in a couple hundred million dollars a year in taxes that the voters will support. One obvious choice: Some kind of bed tax on hospitals. The hospitals might be agreeable to such a plan, given that they'll get much more back from a program that ensures they'll have patients who can pay their bills.

The downside is that the next available chance to vote on such an initiative would be 2014, which means Arizona will be forgoing a big chunk of cash between now and then.


CLOGGING MARANA'S SEWER PLANS

Pima County won a big round in its legal battle with the town of Marana last week when the Arizona Supreme Court declined to overrule an appeals-court decision regarding a wastewater-treatment plant.

Pima County built the plant, but Marana has been coveting it, because they want the potential water credits that come with being able to recharge the wastewater that comes out of the plant.

Marana has tried a variety of legal strategies to seize the plant, but Pima County has outmaneuvered the town in court. We won't get into the nitty-gritty, but the basic outcome of this case means that Marana will have to hold an election to determine whether the town can run the plant.

On top of that, there's a question of whether the town has legal authority under federal law to operate a sewer plant.

Right now, the plant is in the hands of Marana thanks to another state law that allowed the town to take over the plant by promising to pay off the remaining bonds on the facility. Pima County is also challenging that law in a separate lawsuit; county officials say that if Marana is going to take over the sewer plant, they should be on the hook for its full value, not just the bonds that are owed on it.

County officials also warn that Marana residents are going to see their sewer bills rise if the town is successful, because it will cost Marana more to run the plant as a separate entity than it will cost Pima County to keep it as part of the regional system. Marana officials maintain that they can keep costs at the current levels.


ACORN STRIKES AGAIN!

In the wake of last month's election, Public Policy Polling has moved from polling about campaigns to polling about how many people believe in crazy and nonexistent stuff.

The Democratic-leaning firm released a poll last week showing that half of the nation's Republicans believe that ACORN stole the election on behalf of President Barack Obama.

PPP's Tom Jensen notes that a similar question in 2008 showed that 52 percent of Republicans believed ACORN had stolen the election, "so this is a modest decline, but perhaps smaller than might have been expected given that ACORN doesn't exist anymore."

In fiscal-cliff news, the polling firm looked in on the public's attitudes about the Simpson-Bowles deficit-reduction plan. The result: 23 percent of Americans support Simpson-Bowles, while 16 percent oppose it, and 60 percent don't have an opinion.

But here comes the sad part: PPP also polled Americans about the Panetta-Burns plan, "a mythical Clinton chief of staff/former Western Republican Senator combo we conceived of to test how many people would say they had an opinion even about something that doesn't exist," explains Jensen.

A quarter of the respondents had an opinion about the fictional Panetta/Burns plan, which didn't poll as well as Simpson-Bowles: Only 8 percent of Americans supported it, while 17 percent were opposed.


DECK THE TOWN HALL

Tucson City Councilman Steve Kozachik is cooking up a cross between a town hall and a roast to start the new year.

The Koz has invited local politicians who are connected to his midtown Ward 6 to come together from 7 to 9 p.m., Monday, Jan. 7, to talk about the issues facing the community. To liven up the event, he's tapped Arizona Daily Star cartoonist Dave Fitzsimmons to emcee.

Kozachik says he's trying to rekindle some of the goodwill that people on both sides of the political aisle embraced following the shooting rampage on Jan. 8, 2011.

"It is my sense that the combined effect of politics, outside/big money and the passage of time (has led to us) drifting back to the polarized bickering that prevents us from solving some of our fundamental community issues," Kozachik says in a bulletin.

His plan is "a combination of some light sautéing of the elected officials by Fitz, and Q&A from the audience. This is our addressing issues that are meaningful to you in a serious manner, and doing so in an environment in which we won't be allowed to take ourselves too seriously."

It'll be happening at the Loft Cinema, so Kozachik is trying to get advance word out there so he knows whether he should do it in the big auditorium or move it over the Loft's spectacular new theater, which seats just less than 100 people.

He's asking people to RSVP via the Loft at 795-0844, or the Ward 6 office at 791-4601 or ward6@tucsonaz.gov.

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