Three Arizona health care experts gathered at the 2023 Arizona Reform State Health Policy Conference to discuss last year’s legislative session and what they hope to see in the 2024 session. The state budget was one of the main topics of discussion among these people.
Tom Dorn, president of the Dorn Policy Group, an Arizona-based lobbying and public affairs firm, pointed to the $2.5 billion budget surplus that he said was spent on “pet projects.”
He added that because of these expenses, the state is now $400 million short. He thinks Arizona’s $1.5 billion rainy day fund could help, but hopes lawmakers will be careful with the budget to avoid dipping into that fund.
“I think we’re going to look forward to a time when we see budget cuts to state agencies. It remains to be seen what impact that will have on the health care field.”
—Dorn
Amanda Sheinson, director of government relations for the Arizona Medical Association, said finalizing the current state budget is difficult work. For Gov. Katie Hobbs to approve it, there had to be 31 yes votes in the House and 16 yes votes in the Senate.
“That’s why we had to come up with all these projects, to get people involved in the budget… Looking ahead, I think from our perspective, we haven’t even fully recovered from the budget cuts from the recession of 2008,” Sheinson said. .
Sheinson said beneficial Arizona Health Care Cost Containment System (AHCCCS) programs that were intact before the 2008 recession have not yet been restored, such as preventative dental care. People with health insurance through AHCCCS do not receive regular dental care unless they are pregnant or a child, and Sheinson said preventive dental care is essential to the long-term health of ‘an individual. According to Sheinson, the chances of passing a bill on preventative dental care for people receiving AHCCCS in the 2024 legislative session are almost zero.
Behavioral health remains a top concern for lawmakers because it is a very difficult topic, according to Meghan McCabe, director of government relations for the Arizona Hospital and Healthcare Association. Additional wait times in emergency departments are largely due to a lack of available beds, as well as challenges associated with transportation to the specific level of care. McCabe said there is 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 has a significant impact on access to behavioral health, especially for Medicaid enrollees and people with commercial insurance.
“It’s a challenge. I think we’ve all been there. It’s a complex issue: there are many reasons why the workforce is a challenge. At least in behavioral health, Many providers do not purchase commercial insurance and do not take Medicaid. The reason is that it is not cost effective. These insurance programs do not cover the cost of care.
– McCabe
Commercial and Medicaid rates for behavioral health care deserve special attention. Sheinson questioned where commercial and Medicaid enrollees would have to go for care if fewer providers contracted with Medicaid.
McCabe noted persistent rumors that the governor and the Senate would reach an agreement during the 2024 session on his cabinet nominees after his previous term. nominees received backlash earlier this year.
“I don’t know how you come back from an experience that some of his nominees had this year. It was brutal to see professionals who were clearly qualified and at the top of their field being attacked personally and professionally. (It was) upsetting to say the least,” McCabe said. “I think I’m still hopeful that there will be consequences for some of the people who led the efforts to destroy the credentials and qualifications of these candidates.”
McCabe described what happened with the governor’s candidates as a “new low.” She said individuals should engage in representations to lawmakers to express their approval for the candidates they support.
Sheinson shares McCabe’s concerns, but believes good legislation will still be passed in 2024.
“I still think that those of us who are going to promote good policy — I think having good policy that allows for healthy debate distracts from partisan shenanigans,” Sheinson said. “There are going to be things that keep us up at night that are incredibly depressing that we’ll have to have a conversation about, but it’s going to be good.”
Arizona’s legislative session will begin on January 8, 2024.
