5 Things Arizona: Q&A w/ Rep. Salman, Prison health care, Medical debt ballot initiative


Eli Kirshbaum


In this month’s edition of “5 Things We’re Watching” in Arizona, we explore a recent ruling concluding the inadequacy of health care in Arizona prisons, a conversation with Rep. Athena Salman, and an initiative heading to the ballot this fall that aims to reduce the burden of medical debt on patients.

Thanks for reading!

Eli Kirshbaum
State of Reform


1. Prison health care found to be ‘grossly inadequate’ by federal court

After years of allegations that health care for Arizona prisoners has failed to meet basic adequacy levels, a US District Court issued a “landmark” decision late last month that ruled the health care in Arizona’s prisons to be “plainly grossly inadequate” and “unconstitutional.” Judge Roslyn Silver ordered the ACLU—one of the plaintiffs of the original 2012 lawsuit against the state’s prison health care system—to identify neutral experts she can consult with to produce a final order to prison officials to reform the prison health care system.

Advocates have blamed the privatization of Arizona’s prison health care for its failures. Control over the system shifted from the state to the private sector in 2011, and in the subsequent years jurisdiction drifted from one private company to another (during which time the system received several fines for inadequate health care). “When you have this perverse funding scheme, it incentivizes not providing care and not fully staffing the health care positions because basically every dollar that isn’t spent is kept as profit,” says Corene Kendrick, Deputy Director of the ACLU’s National Prison Project.


2. Q&A: Rep. Salman discusses post-Roe Arizona

With Roe v. Wade overturned, multiple conservative Arizona leaders are arguing that a 1901 law banning virtually all abortions in the state is now reinstated. In this Q&A, Democratic Rep. Athena Salman talks about the recent moves she’s seen in the legislature to restrict reproductive health care in Arizona, how certain local jurisdictions might be more proactive than others in seeking to prosecute abortion care providers, and opportunities she sees for protecting this care in Arizona.

Because of the confusing state of Arizona’s current abortion policy, Salman says abortion providers aren’t providing care because they’re afraid of being prosecuted for it. “Instead of just exclusively looking at the health, well-being, and the ultimate desires of the pregnant person and how they want to manage their pregnancy, doctors and providers are having to do additional calculus in Arizona where they have to ask the question, ‘If I provide this health care, am I going to go to prison? Am I going to lose my license?’”


3. What They’re Watching: Dawna Cato, PhD, Arizona Nurses Association

As the CEO of the Arizona Nurses Association, Dawna Cato, PhD, is primarily focused on one policy area: the nursing workforce. With Arizona being one of the states with the worst health care workforce shortages, Cato works with the state to implement policy that will help bolster this critical workforce and meet the demand for nurses that’s only increasing as the pandemic continues.

This work includes the Arizona School Nurse Access Program, the RN Connect text messaging platform, and the Fallen Nurses Tribute. “[The Fallen Nurses Tribute] is where we partner with an organization called Better Place Forest, and they go around and they purchase forest property, and they are helping us create a memorial in the name of the Arizona Nurses Association for all fallen health care heroes.”


4. Arizonans will vote on ballot initiative to reduce medical debt in November

A proposed initiative to protect Arizonans from crippling medical debt reached nearly half a million signatures earlier this month, far surpassing the needed public support to put the initiative on the ballot in November. Supporters of the initiative, including the Arizona Public Health Association, believe it’s a matter of economic justice. Opponents, including the Greater Phoenix Chamber, argue it will make it difficult for lenders to collect debts and harder for Arizonans to access credit.

In addition to capping the interest rate on medical debt at 3%, the Predatory Debt Collection Act would raise the amount of home equity that’s protected from being seized by medical debt collectors from $250,000 to $400,000, raise such protection for vehicles from $6,000 to $15,000, and raise the amount of money in a bank account that’s protected from garnishment from $400 to $5,000.


5. CDC designates multiple AZ counties with ‘high’ community COVID levels

The CDC recently identified 10 of Arizona’s 15 counties as having high COVID-19 community levels as US case rates are at their highest since February. The omicron subvariant BA.5—which accounts for 60% of new COVID cases in the state—is largely to blame for the increase in cases, according to ADHS Interim Director Don Herington.

The named counties include Maricopa, where the case rate is 2.4% higher than the rest of the state (though the death rate is 7.1% lower). Maricopa County’s COVID vaccination rate is 6.7% lower than the statewide rate of 62.5%. Rates of COVID vaccination—which is well-documented as the most effective way to protect against new variants—fluctuate from county to county in Arizona, with 4 other counties lagging below the statewide vaccination rate.