New Fiscal Analysis: The Economic Impact of Federal Medicaid Cuts in Arizona

Rounds Consulting and the Arizona Chamber Foundation published a new report last week analyzing and highlighting the economic impact in Arizona if the Congress and the President follow through with their threat to make states pay more of the share of Medicaid costs for the ‘childless adult’ population from 90% to 65%.

ARIZONA POLICY BRIEF: Federal Medicaid Cuts & Arizona’s Economy

Arizona is in a particularly vulnerable position as we’re a “trigger statute” under the Affordable Care Act, meaning if the feds drop their contribution for childless adult coverage below 80% the fees the hospitals pay AHCCCS to pay the state portion for Medicaid coverage for childless adults goes away – and Medicaid coverage for more than 550,000 adults would evaporate.

The report focuses on the economic realities of losing that coverage rather than the public health impact – and the results are profound.

Here’s a summary of the potential impacts:

  • Funding Loss: A decrease in the enhanced FMAP rates would lead to a $1.9 billion funding loss for the state, which could double the financial strain that Arizona already faces due to changes in Medicaid funding.
  • Medicaid Expansion Discontinuation: If Arizona were to completely end Medicaid coverage for the expansion population, it would result in a significant $7.5 billion reduction in Medicaid spending.
  • Impact on Healthcare Providers: As healthcare providers try to compensate for these funding losses, they may shift some of the costs onto private insurers. This would drive up insurance premiums for both businesses and individuals.
  • Challenges for Small Businesses: Since many Arizona businesses are small, the rising premiums could push employers to cut back or drop their insurance offerings, creating a cascade of negative economic effects.
  • More uninsured individuals will lose access to healthcare coverage.
  • Higher uncompensated care costs, as uninsured individuals may still seek medical care, but providers won’t be reimbursed.
  • Financial strain on hospitals, which may face more unpaid bills.
  • Increased private insurance premiums, further escalating the cost for businesses and individuals.

The economic consequences are severe, with the potential to lose over 36,000 jobs, a contraction of $3.7 billion in economic activity, and a $138 million drop in state tax revenues.

From the Report:

All Arizonans, regardless of their insurance status, would feel the effects of overcrowded emergency rooms, healthcare facility closures, longer wait times for care, fewer medical professionals, a rise in uninsured populations, and increasing health insurance premiums for individuals and employers.

These policy decisions carry significant economic and social consequences. Cuts to Medicaid could destabilize Arizona’s healthcare industry, increase the burden on emergency services, and reduce the overall quality of care for residents.

The healthcare sector, a $38 billion contributor to Arizona’s economy, would suffer greatly, with rural areas facing the most risk due to higher dependence on Medicaid reimbursements. This complex issue could result in long-term damage to both public health and the state’s financial stability.

Perhaps this excerpt from the report says it best:

The primary conclusion from this research is that the economic consequences of federal spending reductions at the scale that are being considered will be significant.

For context, the economic impact on the state of Arizona will fall somewhere between a significant recession and the Great Recession that caused massive fiscal trauma for multiple years.

ARIZONA POLICY BRIEF: Federal Medicaid Cuts & Arizona’s Economy

AzCareCheck 2.0

AZ CareCheck is Arizona’s public online portal that provides comprehensive information about licensed healthcare facilities, including nursing homes, assisted living centers, hospitals, childcare, and behavioral healthcare services.

ADHS – Public Health Licensing – AZ CareCheck

Established in 2010, the platform offers users access to inspection reports, complaint investigations, enforcement actions, and facility details such as names, addresses, and contact information at a host of facilities that ADHS licenses like skilled nursing and assisted living facilities, behavioral health facilities, hospitals, outpatient treatment clinics, community health centers and even childcare facilities.

Sadly, there was very little if any investment in improving the performance of AZ CareCheck during the Ducey era – and many people became frustrated that the system increasingly became difficult to navigate and had missing, misleading & poor and outdated data.

Governor Hobbs recognized the problem and was able to get a line item in the ADHS budget a couple years ago for ADHS to hire a contractor to update the way the system works and to improve the system’s data quality and useability.

ADHS – Public Health Licensing – AZ Care Check

The new AZ Care Check system went live a couple of weeks ago – and by most accounts users say it’s better and easier to use – and appears to have more complete data now.

If you tried it and gave up before, you might try it again now. You can search for licensing history, which may include deficiencies and/or enforcement actions found against facilities/providers. 

Records can be searched by facility/provider name, address, license type/subtype, and licensing status using the search bar and filters.

I’m not claiming AZ CareCheck is perfect – but it’s better than it was during the Ducey/Christ/Herrington era.

Give it a try at: ADHS – Public Health Licensing – AZ Care Check

AG Mayes Files Lawsuit Challenging Kennedy’s $190M+ in Cuts to Arizona Public Health

Last week HHS Secretary Kennedy terminated more than $190 million in multi-year federal grants that were designed to fill holes we found in Arizona’s public health system during the pandemic.

This abrupt and possibly illegal decision has left state and county health departments, along with their contractors, scrambling to address the immediate and long-term impacts on public health services.​

See last week’s blog post to get a flavor for the scale and magnitude of the irresponsible and even dangerous cuts: Kennedy Cuts $190M in Federal Public Health Grants to Arizona – AZ Public Health Association

A significant portion of the funding affected comes from multi-year grants provided by CDC which were all designed to strengthen Arizona’s public health infrastructure in areas in areas identified as weak or vulnerable during the pandemic.

Those improvements were focused on disease surveillance, response capabilities, and health disparities. The sudden loss of these funds means that critical projects aimed at monitoring and responding to health threats are now at a standstill, leaving gaps that could have serious repercussions in future health emergencies and dozens of now half completed projects.

In addition to the CDC grants Kennedy also targeted AHCCCS. Those reductions stem from cuts by Substance Abuse and Mental Health Services Administration (SAMHSA), which plays a pivotal role in funding behavioral health services.

The loss of SAMHSA funds jeopardizes services that many Arizonans rely on for mental health and substance use disorder treatment, potentially leaving thousands without essential care.

Read more about the SAMHSA cuts here: AZ Attorney General Kris Mayes says federal grant cuts are illegal

Fortunately, we have an Attorney General who is vigilant, recognizes the danger to Arizona’s public health system that the cuts pose – and who also believes that the contract cuts were illegal.

Last week she joined a coalition of attorneys general in suing Kennedy, arguing that the abrupt termination of these grants violates federal law and harms public health nationwide. The lawsuit looks to restore funding and prevent further disruptions to essential health services.

See ADHS’ Complaint Challenging Kennedy’s AZ Public Health System Cuts

See AHCCCS’ Complaint Challenging Kennedy’s Behavioral Health Cuts

Update: A ruling April 3 by U.S. District Judge Mary S. McElroy in Rhode Island bars the U.S. Department of Health and Human Services and its agencies from implementing the cuts while case moves forward.

Boost Your Career Potential with an Affordable Online Degree

If you’re an Arizona Public Health Association member, employee, or the spouse or legal dependent of a member or an employee, you can take advantage of several education benefits thanks to an alliance with University of Maryland Global Campus, a leader in online education for working adults. Save up to 25 percent on out-of-state tuition for most UMGC programs and get your $50 application fee waived when you apply as a new student.

Arizona Public Health Association Alliance | UMGC

As an AZPHA member you qualify for a discount will be applied to out-of-state tuition for eligible students in most programs. Discounted tuition rates may not fall below the standard in-state rate or any special tuition rate offered to eligible active-duty military servicemembers, their spouses, or dependents.

You can learn more by clicking here: Arizona Public Health Association Alliance | UMGC

Maricopa County Commits $4.3M in Opioid Settlement Funds to Strengthen Local Response

Maricopa County is investing approximately $4.3 million in opioid settlement funds to support 17 local organizations working to combat substance use and its devastating impacts on individuals and families. 

“The opioid and polysubstance use crisis continues to impact families across Maricopa County, and these funds allow us to take meaningful action,” said Thomas Galvin, Chairman of the Maricopa County Board of Supervisors, District 2. “By providing more resources to organizations who are on the front lines of this battle, we are building a stronger, more coordinated response to help those affected.”

This funding is in accordance with the One Arizona Distribution of Opioid Settlement Funds Agreement and will expand services at three existing opioid settlement-funded organizations while also supporting 14 new organizations (see chart below). 

Investments will enhance prevention and treatment programs, expand harm reduction interventions, increase recovery support, and improve care coordination to ensure that services reach those most in need. Awarded contracts will begin on April 1, 2025, and are renewable up to four additional years subject to Board of Supervisor approval.

Funded projects align with Maricopa County’s Substance Use Prevention & Response Strategic Plan for Fiscal Year 2024-2028.  The County’s approach prioritizes evidence-based and culturally-appropriate solutions that address immediate needs while also building long-term resilience in communities disproportionately impacted by the opioid epidemic. 

Contracts were selected through a competitive bid process. Future opportunities to apply for Maricopa County opioid settlement funds include a Request for Proposals (RFP) coming in April 2025.  

This RFP will fund a single provider to expand business-focused substance use toolkits and deliver technical assistance to small, medium, and large organizations in Maricopa County. This project will help businesses develop and implement workplace policies addressing substance misuse. Interested parties can register with the county online

A current list of all current organizations and projects funded by Maricopa County Opioid Settlement Funds is available here. In addition to Maricopa County, opioid settlement funds are distributed to most of the cities and towns in Maricopa County.  For a complete list of settlement spending in the county and state, please visit the Arizona Attorney General’s website.