Why One Of Obama's Most Visible Foes Became His Biggest Ally In Obamacare

With a loud, very public finger wag 18 months ago, Arizona Gov. Jan Brewer became something of a conservative symbol for opposition to President Barack Obama.

The image on the tarmac couldn't be further from memory after Brewer became one of Obama's biggest conservative allies in expanding Medicaid, a key provision of the Affordable Care Act that many Republican-controlled states are still resisting.

Brewer made her position on Medicaid expansion well-known in January, but she faced backlash from a Republican-controlled legislature. Brewer argued that the logistics for expanding the program made simple sense: It will expand coverage to more than 240,000 poor residents next year, while the federal government picks up the tab for the first three years of the program's expansion.

“As an elected official of more than 30 years, I know that this process was not easy or without political risk," Brewer said in a statement after a bipartisan coalition of moderate Republicans and Democrats in Arizona's legislature sent her a bill on Thursday.

"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," she said, in reference to threatening calls and letters sent to state legislators during the heated debate.

Brewer took a scorched-earth approach, however, to getting her way. After it became clear she would face staunch opposition among a confounded group in the legislature, she vowed to veto all bills until the state addressed Medicaid expansion and passed a state budget.

She made good on that threat, vetoing five bills in late May after Arizona state Senate President Andy Biggs decided to test her resolve.

"It is disappointing I must demonstrate the moratorium was not an idle threat," Brewer said in a statement after vetoing all five bills. "I respectfully ask that legislators join me to resolve our budgetary and health care challenges. Once these primary issues are behind us, I am happy to once again consider unrelated legislation."

In getting her way, Brewer has made Arizona the 23rd state to embrace Medicaid expansion, according to the Kaiser family foundation. Twenty states are against expansion, and seven states are still undecided.

Some of those seven states are due for a similarly heated debate as Arizona's. In Michigan and Ohio, Republican governors Rick Snyder and John Kasich face opposition from Republican-controlled legislatures.

Michigan's House recently approved the expansion, and Scott has pushed the more Republican-controlled Senate to follow suit. In Ohio, meanwhile, Kasich has gone to extraordinary lengths to advance support, suggesting it's something that former President Ronald Reagan would do.