The Arizona Senate has passed an $8.8 billion budget that includes expanded Medicaid access and marks a huge political victory for Republican Gov. Jan Brewer.
Ironically, the victory over the Medicaid expansion aligns Brewer with a key part of President Barack Obama's healthcare overhaul law.
Brewer has often been at odds with the president and is remembered for shaking a finger in the president's face during a visit to Arizona.
The Medicaid expansion is optional under last year's Supreme Court decision upholding the federal health care law. Many Republican governors rejected it. About 1.3 million Arizonans already are covered by the state's plan.
The governor issued the following statement moments after passage and just before the special session ended:
"With landmark votes today in the House and Senate, legislators have tackled the issue that is Job One every session - adoption of a responsible State budget - and enacted Arizona's most sweeping health care legislation in decades.
"As an elected official of more than 30 years, I know that this process was not easy or without political risk. By joining me in extending health coverage to hundreds of thousands of Arizonans, legislators of my own party have come under sharp criticism in some quarters. Some have had threats made not just against their political future, but also their personal livelihood.
"But I also know this in my heart: The great majority of Arizonans stand with us. Our citizens have - time and again - voted to extend cost-effective care to the working poor. Over the last five months, more than 400 community groups have rallied behind our effort. They include nurses and doctors … who described the desperate plight of uninsured Arizonans forced to seek care in the emergency room. Business leaders … who pay the Hidden Health Care Tax that results from this uncompensated care. First responders and members of law enforcement … who see the human toll on our streets and in our communities as so many Arizonans with mental illness lack access to basic care.
"Most of all, I remember the people. I remember Laura Gargiulo, a single mother who was diagnosed with Stage 3 breast cancer. She credited Arizona's Medicaid program, known as AHCCCS, with saving her life.
Or Justin Smith. Like so many others, he lost his job - and his health insurance along with it - during the Great Recession. Then he got sick. Emergency medical care saved his life, but he is now strapped with $200,000 in hospital bills. Hundreds of thousands of uninsured Arizonans walk the same tightrope every day, knowing they are a single car wreck, illness or accident from financial ruin. Through this process, I have been humbled by the support of Arizonans like Laura and Justin. They are my strength.
"This Medicaid Restoration Plan does not solve all of Arizona's health care challenges. But it will extend cost-effective care to Arizona's working poor, using the very tax dollars our citizens already pay to the federal government. It will help prevent our rural and safety-net hospitals from closing their doors. And it will boost our economy by creating more than 20,000 jobs at a time when Arizona needs them most.
"I thank the Arizona Legislature for joining me in putting the people of Arizona first."
The budget has pitted many Republican legislators against Brewer. Earlier Thursday, the House approval came at about 2:30 a.m. as a result of efforts from a newly formed coalition of Democrats and GOP moderates.
According to a news release issued by Democrats early Thursday morning, the House-passed budget also provides:
The Senate previously approved a version of the budget with little debate Wednesday evening while the House wrapped up its floor session in the early morning hours Thursday.
Conservatives proposed more than 50 amendments Wednesday night but didn't have the votes to stop the Medicaid expansion or the budget deal.
In a statement Wednesday night, Brewer said, "It's time to finish the people's business."
"Majority," Brewer wrote. "That word has meaning in our republic. I trust that over the next 24 hours or so, a majority of the House and Senate will put an end to the games. They will take action on a budget and Medicaid restoration and finally complete the people's business."
Brewer used her gubernatorial power to call a special session of the legislature late Tuesday with little notice.
She posted the call for the special session on her Twitter account about 5 p.m. Tuesday. Her power play came after the legislature had adjourned for the day.
Her action sparked anger from House Speaker Andy Tobin and Senate President Andy Biggs, who issued a joint statement that said Brewer acted with "overt hostility" by calling the session.
"We are frustrated and bewildered by her overt hostility and disregard for the budgetary process which was already well underway," their statement read. "The blatant disrespect and reckless practices exhibited by this executive are less than what was expected of her and more than should be tolerated."
Republican Rep. Adam Kwasman also took issue with the governor's order.
"I rise today to stand firmly against this special session," Kwasman said Tuesday night. "There is absolutely no need to hold a special session."
Democratic House Minority Leader Chad Campbell released the following statement on behalf of the Arizona House Democratic Caucus:
"From day one, House Democrats have been committed to passing a common-sense budget that fosters job creation and increases funding for education. We've also been steadfast in our support of Medicaid restoration because it will help hundreds of thousands of Arizonans get access to healthcare, bring millions of dollars into our economy, benefit hospitals and create jobs.
"We view this special session as an opportunity to focus on these pressing issues. House Democrats remain ready to work. For months, political games have been the priority at the Capitol. Arizonans are tired of the partisan bickering. They have made it clear that they want us to move our state forward in a bipartisan manner.
"The budget and the debate on Medicaid restoration are long past due. The legislature has one constitutional obligation and that is to pass a budget. We know there are enough votes to do that and to restore Medicaid right now. It's time for the political grandstanding to stop and for the obstructionist tactics to end. It's time to vote."
The House had been expected to take up Brewer's Medicaid expansion proposal early Tuesday, but Tobin opted to instead delay that and other budget-related votes until Thursday.
Brewer has repeatedly voiced her displeasure with the legislature's sluggish pace this session as conservative Republican leaders have refused to pass her proposal to expand Medicaid to 300,000 more poor residents under the federal healthcare law.
A House committee dominated by conservative Republicans rejected the Senate-passed budget bill that contained the Medicaid provision Monday. In addition to opposing the Medicaid expansion, Republicans said the Senate-approved budget contains too much spending.
Copyright 2013 CBS 5 (KPHO Broadcasting Corporation). All rights reserved. The Associated Press contributed to this report.