5 Things Arizona: Q&A w/Rep. Cobb, ACA subsidy expansion, “Chronic COVID”

Traditionally, our annual State of Reform conference is in May. Last year, because of COVID, we postponed the event into the fall. But this year, we’re getting things back on track. So our 2021 Arizona State of Reform Health Policy Conference will be held May 25th this year.

I think we all want to be back in person — but I don’t think we’re going to be quite ready yet come May. Item 5 below helps inform that. So, we’ll be virtual again in this year’s event. Since our last conference, we’ve built out more tools for networking, including “round table” discussions and specific networking events. So, I think you’ll find it to be a unique experience among virtual events.





With help from Emily Boerger

1. Telemedicine and broadband are top priorities for Rep. Cobb

Representative Regina Cobb, DDS, serves as Vice Chair of the House Health and Human Services Committee and as Chair of the House Appropriations Committee. In this Q&A, Cobb discusses the health bills she is pursuing this session, the dynamics of the HHS Committee, and how her experience as a dentist has influenced her legislative work.

Cobb says her top priorities this year are her telemedicine bill and legislation to invest in broadband to support telehealth and education. Cobb says her co-sponsored bill, HB 2291, which would require AHCCCS contractors to provide comprehensive dental care to eligible pregnant women, “is still in play as far as the appropriations and what we do in the budget bill.”


2.  AzHHA, AzNA, and ArMA discuss session

In a series of interviews with State of Reform, the Arizona Hospital and Healthcare Association (AzHHA), the Arizona Nurses Association (AzNA), and the Arizona Medical Association (ArMA) offered insight into their approaches to this year’s legislative session. AzHHA says it’s focused on civil liability protections and telehealth expansion. AzNA says its supporting legislation to create the “Nursing Workforce Preparation and Shortage Work Group,” along with other bills to support nursing education.

ArMA discussed three bills they are actively opposing this year including SB 1271, which would grant a one-year transitional training permit to eligible medical school graduates if they don’t get into a residency program, SB 1374, which establishes requirements for a Crisis Standards of Care Plan, and SB 1300, which would change the rules concerning which professionals need to be present while a patient is anesthetized.


3. Health reform in federal COVID bill

The $1.9 trillion COVID relief package currently working its way through Congress has become a magnet for consequential health reform measures. In his latest piece, State of Reform Columnist Jim Capretta outlines the health measures in the bill that “will be significant for policy debates in the years ahead.”

Among the list of changes is an increase in premium tax credits for households receiving insurance through the ACA exchanges. The bill would fully subsidize coverage for households below 150% FPL, it would increase subsidies for those up to 400% FPL, and it would remove the 400% FPL cap, allowing any household to get coverage through the ACA exchanges with a premium of no more than 8.5% of annual income.

recent analysis estimates that for an enrollee in Arizona at 430% FPL, the expanded subsidies would decrease monthly premiums from $726 to $198 (lowest-cost bronze), $925 to $390 (benchmark silver), and $1,175 to $640 (lowest cost gold).

4. Run down of some notable legislation

We’ve seen some health policy movement this month with Gov. Ducey signing his first batch of health care bills and with lawmakers acting quickly in anticipation of last Friday’s deadline to pass bills out of committee. Looking ahead, we’re tracking a batch of bills aimed at protecting health care workers along with other legislation related to overdose and disease prevention programs.

We also have our eye on several mental health-related bills including SB 1097, which would allow students to have excused absences for mental health reasons, SB 1376, which would require mental health to be included in the state’s health education curriculum, and SB 1220, which would provide trauma counseling from licensed mental health professionals for firefighters/peace officers.


5. Implications of “chronic COVID”

I recently had the opportunity to speak with Dr. Chris Murray, Executive Director of the Institute for Health Metrics and Evaluations (IHME), where I learned something I didn’t know. Based on data from the Novavax COVID vaccine trial, being previously sick with COVID-19 appears to offer no protection from being infected with the new South African strain of the virus.

Without cross-variant immunity, Murray says this data indicates we may be moving to a “world of chronic COVID” where every winter we treat COVID as we do the flu. I outline three immediate things that may change for us in this column. Perhaps the most important is this: hospitals and their current financing models are in trouble. Video of my full conversation with Murray is available here.