PHOENIX -- Calling the governor's proposal unacceptable and politically unsalable at the Legislature, House Speaker Andy Tobin unveiled a new plan today to expand Medicaid -- and give Arizona voters the final say.

The measure would allow Arizona to add about 300,000 to the rolls of the Arizona Health Care Cost Containment System on top of the 1.3 million already enrolled. That is identical to what Gov. Jan Brewer wants to do.

But Tobin's plan puts far more strings on the tax on hospitals that would be needed to pay the state's share of the plan. That includes giving authority over the size of the levy to a legislative committee and not, as Brewer wants, the head of the state's Medicaid program.

Tobin also includes provisions designed to cut health care costs and add money for graduate medical education, language he said is lacking in the plan unveiled by the governor in January. And there is funding for medical research for everything from heart disease to preventive care.

All that, he said, deals with the problems of high health care costs rather than the symptoms.

"What drives down the cost is better health care," he said.

More controversial is a separate measure designed to restrict, if not bar, any of the funds from going to organizations which also provide abortion "because we're a pro-life Legislature."

The big change, though, is making the entire package subject to voter approval -- and a self-destruct date of Dec. 31, 2016 -- neither of which is in Brewer's plan. In fact, the governor has repeatedly rejected suggestions that the issue be referred to voters.

Tobin's move comes as Brewer is making another bid to pressure lawmakers themselves to adopt her plan. She is planning a rally on the Capitol lawn on Wednesday, her fourth since trotting out the plan in January.

Others have included hospitals, health care providers and patients. This new one features special interest groups like the Children's Action Alliance and the American Association of Retired Persons.

But Tobin said there just aren't the necessary votes, at least in the House, for what Brewer wants. He said the governor should welcome any alternative that gets her the expansion she wants, even if it's not her way.


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