Three Arizona healthcare experts met at the 2023 Arizona State of Reform Health Policy Conference to discuss this past year’s legislative session, and what they hope to see in the 2024 session. The state’s budget was a primary topic of discussion amongst these individuals.
Tom Dorn, president of Dorn Policy Group—an Arizona-based lobbying and public affairs firm—highlighted the $2.5 billion budget surplus that he said was spent on “pet projects.”
He added that due to these expenditures the state now has a $400 million shortfall. He believes Arizona’s $1.5 billion rainy day fund might help, but hopes lawmakers will be prudent with the budget to avoid tapping into that fund.
“I think we’re going to be turning to the days where we see budget cuts in state agencies—how that’s going to impact the healthcare field remains to be seen.”
— Dorn
Amanda Sheinson, government relations director of the Arizona Medical Association, said getting the current state budget finalized was hard work. To get Gov. Katie Hobbs to sign off on it, there had to be 31 House votes and 16 Senate votes in favor.
“That’s why we had to offer all of these projects—to get people on [board with] the budget … Looking ahead, I think from our perspective, we haven’t even fully recovered from the cuts of the 2008 recession,” Sheinson said.
Sheinson said beneficial Arizona Health Care Cost Containment System (AHCCCS) programs that were intact prior to the 2008 recession have yet to be restored, like preventative dental care. Individuals receiving health insurance through AHCCCS do not receive regular dental care unless they are pregnant or a child, and Sheinson said preventative dental care is core to an individual’s long-term health. According to Sheinson, the chances of passing a preventative dental care bill for individuals on AHCCCS in the 2024 legislative session is next to nothing.
Behavioral health remains a top-of-mind concern for the legislature since it is such a challenging topic, according to Meghan McCabe, director of government relations of the Arizona Hospital and Healthcare Association. Backup wait times in emergency departments are largely due to a lack of available beds, as well as challenges associated with transportation to the accurate level of care. McCabe said there’s an agreement among state lawmakers that something needs to be done.
“I don’t think there’s agreement on what that something is,” McCabe said.
McCabe said the healthcare workforce shortage is having a significant impact on behavioral health access, particularly for Medicaid enrollees and individuals receiving commercial insurance.
“It is a challenge. I think we’ve all experienced that. It’s a complex problem—there are many reasons why the workforce is a challenge. At least on behavioral health, there are a lot of providers that don’t take commercial insurance, and don’t take Medicaid. The reason is, it’s not cost effective. Those insurance programs are not covering the cost of care.”
— McCabe
Commercial and Medicaid rates for behavioral healthcare warrants attention. Sheinson questioned where commercial and Medicaid enrollees should go to seek care if fewer providers are contracting with Medicaid.
McCabe noted ongoing rumors that the governor and the Senate are going to come to an agreement during the 2024 session on her cabinet nominees after her previous nominees received backlash earlier this year.
“I don’t know how you come back from an experience that some of her nominees had this year. It was brutal to watch evidently qualified professionals at the height of their field be attacked personally and professionally. [It] was upsetting to say the least,” McCabe said. “I think I am ever hopeful that there will be consequences for some of the folks who led the effort to tear down the credentials and the qualifications of those nominees.”
McCabe described what happened with the governor’s nominees as a “new low.” She said individuals should engage in outreach to legislators to voice approval for the candidates they support.
Sheinson agreed with McCabe’s concerns, but believes good legislation will still be passed in 2024.
“I still think that those of us out there that are going to be pushing good policy—I think having good policy out there that we can have healthy debate distracts from the partisan shenanigans,” Sheinson said. “There will be things that will keep us up at night, and are incredibly depressing, that we need to have a conversation about—but there’s going to be good.”
The Arizona legislative session will begin on Jan. 8th, 2024.