PHOENIX - With her plan to expand Medicaid backed up against a political brick wall, Gov. Jan Brewer is trying to ratchet up the pressure on Republican lawmakers.
Brewer took her case to the steps of the House and Senate on Wednesday to let supporters tell their story - the fourth such rally she has organized, this one featuring a doctor, a firefighter, a veteran and a hemophiliac.
That last speaker, Tempe resident Brent Davila, has a personal interest in what lawmakers do.
He is a single adult enrolled in Medicaid. And unless lawmakers approve the expansion Brewer wants - or some alternative - he will lose coverage at the end of the year.
Davila said he cannot afford that, since a single dose of his medication costs nearly $3,400.
"All hemophiliacs are different," he told those at the rally.
"Most do not need medication nearly as frequently as I do," Davila continued. "However, people like me must perform an IV of this medication every 48 hours in order to avoid serious complications."
Gary Figge, an emergency room doctor at Northwest Medical Center in Tucson, said he sees every day the problems of "cost shifting."
That's when people need care but do not have insurance, so the hospital must make up the difference with higher charges to others.
Brewer proposes to take advantage of a provision in the Affordable Care Act that allows states to offer free care for those below 138 percent of the federal poverty level. The federal government will provide about $1.6 billion, with Brewer proposing the state's share of $250 million paid by what amounts to a tax on hospitals.
Most hospitals have been willing to go along under the presumption they will come out ahead by reducing the number of patients who have no insurance and can't afford to pay.
While Brewer says without some form of expansion coverage for people like Davila will expire on Dec. 31, Senate President Andy Biggs and House Speaker Andy Tobin say there are other options to continue coverage for at least some patients, other than Brewer's plan. They raise concerns about the federal program continuing to pay for expanded coverage in the future, leaving the state to pick up the cost, about the legitimacy of the hospital assessment, and about some of the money going to Planned Parenthood.
Brewer also faces philosophical objections to the Affordable Care Act, often referred to as Obamacare.
Brewer pointed out that she joined with officials from other states to challenge the law.
"We lost. The president won. The Supreme Court upheld it," the governor said. "Now we've got to do the best we can do for Arizona."