PHOENIX  Gov. Jan Brewer penned her approval Thursday to a package of bills designed to balance the budget for the balance of this year and next — in large part by cutting health care for the poor.

Brewer, at a press conference to criticize the Democratic health care plan being considered in Washington, said the state had no choice but to eliminate free health care for more than 310,000 now enrolled in the Arizona Health Care Cost Containment System, the state’s Medicaid program. The budget also eliminates the Kids Care program that provides nearly free care to more than 40,000 children of the working poor.

The governor acknowledged that will increase the number of people in the state without coverage.

“We do not have the money,’’ she said. “We are broke.’’

And what of the increase in the number of people who cannot afford health insurance?

“It is painful,’’ she responded. “We cannot take care of everybody, every day, for every thing.’’

Pressed for where these people will get care, Brewer said she expects they will show up in hospital emergency rooms and clinics.

“It is done,’’ the governor said. “And we need to move forward.’’Brewer said that even though the budget creates more uninsured, that does not make the health care plan being pushed by the Obama administration and awaiting a congressional vote a viable alternative.

“We can’t afford the Obama offer,’’ she said, claiming that her analysis of the plan would cost the state even more than it is spending now.

But Rep. Kyrsten Sinema, D-Phoenix, argued that the plan, if adopted, would save Arizona money in the long run.

Health coverage aside, the budget Brewer signed on Thursday is built on a bunch of presumptions of what voters  and courts  will do.

The biggest of these is the proposed 1cent hike in the state sales tax, to 6.6 percent, that will appear on the ballot at a May 18 special election. Estimates show that would raise about $918 million in the first year of its threeyear existence.

But lawmakers and Brewer also are counting on voters agreeing to scrap the First Things First program in November just four years after they had approved it. That would given lawmakers access to the proceeds from then 80centapack tax on cigarettes which was part of the initiative to fund new programs for early childhood development, a levy that raises about $150 million a year.

It also would let them take an estimated $325 million already accumulated.

Also on the November ballot is a request to voters to let lawmakers take more than $123.5 million set aside to purchase open space around urban areas. That OK is needed because the fund was mandated by voters in 1998.

And the Arizona Hospital and Healthcare Association is planning to challenge the provision which cuts AHCCCS eligibility.

The requirement to provide coverage for everyone below the federal poverty level was part of a 2000 initiative. That, coupled with the state’s economic slump, has ballooned enrollment to close to one out of every five Arizonans.

Legislative leaders said the language of the initiative lets them roll back the program because there are not other “available’’ funds. But initiative backers, including the hospitals, contend the language forbids lawmakers from cutting eligibility.