Gov. Jan Brewer  led a lively “pep rally” for Medicaid expansion at Tucson Medical Center this morning , drawing cheers, shouts of support and a standing ovation from about 250 local healthcare executives, business leaders and regular citizens.

Without the expansion, about 60,000 Arizonans now enrolled in Medicaid will immediately lose health coverage at the end of 2013, including including an estimated 5,000 cancer patients and 2,000 Arizonans with serious mental illness, state officials say. And hospitals and people with health insurance will end up shouldering the cost, Brewer said. She said the state would also lose out on millions of dollars in federal matching funds to cover healthcare.

“We cannot let that happen,” she said to loud applause. “And I know that we won’t.”

Medicaid is a federal insurance program for low income people that currently covers 1.3 million Arizonans. Many of the Arizona critics against the expansion are also opposed to the new federal health law. Some say Medicaid needs major reform and that expansion shouldn’t be done without an overhaul.

“Now, I am no big fan of the Affordable Care Act. In fact I led Arizona’s efforts to defeat it. But the question for Arizonans today is not whether the law should exist. It does. The Supreme Court upheld it,” Brewer said. “The question is whether we will take decisive action in a way that most benefits Arizona’s families, businesses and hospitals.”

The expansion got a significant boost last week when the Arizona Senate approved the plan, but it still needs support from the state House of Representatives. House Speaker Andy Tobin , a Republican from Yavapai County, has said he wants the expansion to be subject to voter approval, which the governor opposes.

“Now we move to the House of Representatives and the road doesn’t get any easier,” Brewer said.

Expansion of Medicaid is one of the new healthcare law’s provisions. While the law calls for expanding Medicaid to people who earn up to 133 percent of the federal poverty level, the U.S. Supreme Court last year left the question of whether to expand Medicaid up to individual states.

The Arizona Legislature froze childless adults from enrolling in Medicaid in 2011 because of $2.5 billion in annual budget cuts to the program. Since then, the number of Arizona childless adults with Medicaid has shrunk by more than 60 percent, leaving about 240,000 childless adults in Arizona without health insurance. As a result, hospitals say their costs for bad debt and uncompensated care has skyrocketed.

With the federal matching funds, the state would be able to restore coverage to those 240,000 childless adults and continue coverage for about 60,000 others.

“These are Arizonans without health insurance who live day to day knowing they face disaster if they get sick, or if they are injured,” Brewer said.

In Arizona, Medicaid is available to people who earn up to 100 percent of the federal poverty level, which works out to an annual income of $19,530 for a family of three. Taking that cap up to 133 percent would work out to nearly $26,000 in income for a family of three.

The governor surprised many people earlier this year when she announced that she would support expanding Medicaid, a program that in Arizona is also called the Arizona Healthcare Cost Containment System or AHCCCS.

The expansion would cover an additional 57,000 Arizonans. But more significantly, the expansion would give what state officials say is enough federal matching funds to cover childless adults.

“Illness doesn’t wait until it’s convenient or when you save enough money to pay for medical care,” said Judy Rich , who is the president and chief executive officer of Tucson Medical Center. “Hospitals have served as a vital safety net as the state has struggled through our great recession. Now it’s time to invest in the health of our community, support Tucson and Arizona hospitals and the broader health safety net.”

Senior Editor, News, Arizona Daily Star, Tucson, Az.