Humble presents legislative report on public health in Arizona

Arizona Public Health Association (AZPHA) Director Will Humble delivered a legislative report on public health at the 2020 Winter State of the State Conference, hosted by the Hertel Report.  

The presentation outlined how uncertainty at the federal level is trickling down to impact the public health conversation in Arizona, as well as bills he’s keeping an eye on this session. Below are the highlights.

 

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The legal fights and politics surrounding the ACA

The presentation began with a federal issue that would have an enormous impact on public health in every state: Texas V. Azar. 

Arizona, due to the efforts of Attorney General Mark Brnovich, is one of 20 states challenging the constitutionality of the ACA. On Dec. 15, the 5th U.S. Circuit Court struck down the ACA in its entirety due to the zeroing out of the tax penalties associated with the ACA’s individual mandate.

The latest appeal in New Orleans ruled in favor of the plaintiff but was sent back to Texas so that more specifics could be explored regarding the severability of the ACA.

The plaintiffs filed a request for an expedited review, which was denied by the Supreme Court.

Humble’s presentation also highlighted the shifting political terrain on which the ACA stands.

Since the 2012 decision upholding the ACA, the supreme court has tilted to the right with the additions of Justices Gorsuch and Kavanaugh. The 2012 (5-4) decision was predicated on an argument affirming the taxing authority of Congress, and now the tax is gone.

The presentation also lays out what has been a key wedge issue in this fight: protections for people with pre-existing conditions.

Prior to the ACA, Humble reminds, standards to protect people with preexisting conditions were determined at the state level. Also in the pre-ACA era, insurers maintained long lists of conditions that disqualified applications from insurance or resulted in higher premiums. 

A 2020 ballot initiative has been filed to codify some ACA benefits into Arizona law.

Legislative update

Uncertainty over the ACA aside, there are plenty of public health bills working their way through the legislature this session.

Concerning vaping control, HB2637 & HB2173 would classify vaping products in the same category as tobacco. Vape pens would be subject to the same laws and rules that govern tobacco sales and use. Additionally, these bills would permit cities and towns to impose stricter regulations at their discretion.

Next, Humble singled out two bills related to oral health. HB2423 and SB1170 seek to expand covered services to include preventative dental coverage during pregnancy.

On the injury prevention front, HB2608 would decriminalize syringe access programs. The goal is to allow organizations that promote scientifically proven ways of mitigating health risks associated with drug use and other high‑risk behaviors to establish overdose and disease prevention programs.

Vaccines are always a hot button issue. Humble made note of two controversial pieces of legislation that weaken immunization requirements.

HB2050 would, according to Humble, “essentially get rid of the current system by which schools track whether students are vaccinated or not.” Furthermore, he warned that HB2486 basically does away with the FDA vaccine approval process and replace it with criteria set by this law for the purposes of implementing vaccination requirements.”