Poll: Arizonans more concerned about access to health care for those with pre-existing conditions than COVID-19

Arizonans are more concerned about access to health care for those with pre-existing conditions than the COVID-19 pandemic, according to a recent poll by the Commonwealth Fund.

The poll results may not come as a surprise when looking at recent Census Bureau data, which shows that over 800,000 Arizonans didn’t have health insurance as of last year. That figure could grow in 2021 due to high levels of unemployment, and loss of employer sponsored insurance by extension, brought on by the pandemic.

Jim Hammond, publisher of the Hertel Report and one of Arizona’s leading health policy experts, offered his analysis of the poll results and the ACA more broadly during a recent interview with KJZZ. A transcription of the interview is available below.


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KJZZ: 2019 marked the third consecutive year in which the number of Arizonans without health insurance went up. What might have caused this increase

Jim Hammond: The mandate that came along with the Affordable Care Act has been nullified with the tax break that the Trump Administration put in and was passed by Congress. So we don’t have a mandate that you have to buy health insurance anymore. The second thing is just price. I think it’s too expensive for people, whether they get assistance from the federal government or not, premiums are just too expensive for people to afford.”

KJZZ: Given the ongoing litigation is there confusion about whether the ACA is still around or how useful it might be?

JH: Yes I think that is a fact. There is confusion about whether people really need to have health insurance or not. So, I think some people may have decided, ‘well I don’t have to buy it so that’s why I’m not going to pay my premium this year. I think for most people, it’s a really a matter of economics. If you are spending more than 10% of your income on health insurance premiums, you begin to wonder whether it’s really worth it.”

KJZZ: Why did the rates go up so much?

JH: The rates have gone up got a couple of reasons. From my perspective, the industry itself just does not get any cheaper. Every year, we have a thing in the industry we call trend, and the trend is always above inflation. So if inflation is at one or two or three percent, but trend in health care is at three or four or five percent, then every year we lose purchasing power buying health care premiums.”

KJZZ: 2020 has been marked by the pandemic. Do we have any idea of how much worse the uninsured rate will get this year?

JH: There aren’t any numbers in on that. We are going to see what happens with the supreme court and whether or not the ACA gets rolled back but we don’t really know what people are going to buy, we don’t know if they’re going to buy plans or not. But the insurance industry is banking on people buying insurance because they’re adding coverage areas. We’re probably going to get a new player in our market, so even when the rates are high and people are not buying as much as they used to, the insurance industry is still expecting people to be buying this fall.”

KJZZ: Why did the pandemic rank lower than access to health care for those with pre-existing conditions in the recent Commonwealth Fund poll measuring what health care issues Arizonans were most concerned about?

JH: There is a lot of discussion around preexisting conditions because people are protected for being excluded from coverage. That’s just in the news because of the election and because of the attempt to repeal the ACA. There is a very real possibility that if the ACA is overturned, a lot of people will now have preexisting conditions and their insurance companies will have the ability to exclude them from coverage. Half the people in the country probably qualify for a preexisting condition. It would be turmoil to see what the insurance companies would do and if they are going to actually kick them off of plans and tell them they can’t get coverage for their bad back because that’s a preexisting condition. I think it’s just a real concern that the insurance plan you have now will not help you next year.”