Kennedy Cans Everybody Who Calculates the Federal Poverty Limit: Is his Goal to Set the FPL Artificially Low Next Year to Kick People Off Safety Net Programs?

Eligibility for federal safety net programs like Medicaid, SNAP, WIC, and Kids Care requires that applicants establish that they financially qualify.

In order to do the means-testing we need to be able to compare a family’s income to a benchmark to make sure they really need and qualify for a benefit like Medicaid, SNAP or WIC. That benchmark is called the ‘federal poverty level’ (FPL).

For several decades, the federal government has had a small crew of objective and apolitical statisticians who specialize in using economic data to set up the FPL.

The team takes Census Bureau poverty-line figures, adjusts them for inflation, and creates the FPL for the country each year (Alaska and Hawaii have a different FPL than the rest of the US).

This week Secretary Kennedy fired all the staff who do the rigorous and unbiased calculation of the FPL this week. Well, actually, he put them on administrative leave until June 1, at which point they’ll all be canned.

Trump HHS Eliminates Office That Sets Poverty Levels Tied to Benefits for at Least 80 Million People – KFF Health News

HHS will still need to develop an FPL annually – but they’ll no longer have the staff to do it.

Perhaps one of the DOGE bros will take a few minutes and make one up from now on.

There’s a good chance that the mass firing was done so Kennedy/Musk can set their own (arbitrarily low) FPL next year to kick millions of people off safety net programs like Medicaid, SNAP, WIC, and marketplace cost sharing subsidies.

Time will tell – but these guys are good at finding where the hinge points are so they can cause as much damage as possible with the least possible effort.

Arizona Justice Reinvestment Grant: Does Your Organization Want to Apply?

If your organization supports people affected by substance use or the justice system, you may qualify for a new grant opportunity known as the Arizona Justice Reinvestment Grant. As part of Proposition 207 (Smart and Safe Act aka retail marijuana) Arizona funds organizations that help these communities and persons who were victims of overcharging for marijuana possession by county prosecutors.

This grant is designed for organizations working on:

  • Substance use prevention, treatment, and early intervention
  • Reentry, diversion, rehabilitation, and job training for individuals affected by the justice system
  • Addressing factors that contribute to crime and supporting community safety initiatives
  • Restoring civil rights and clearing charges from records (also known as expungement)

Justice Reinvestment Grant Information Session 4/17/25 9-11am

Justice Reinvestment Information Session 4/24/25 9-11am

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.

Kennedy Cuts $190M in Federal Public Health Grants to Arizona

In a move coordinated with Kennedy’s announcement of mass layoffs at HHS agencies and the closing of regional service offices, Secretary Kennedy also immediately terminated more than $190 million in cooperative agreement funds for Arizona public health infrastructure & initiatives.

Feds withhold $190M in public health grants to Arizona, AZCentral – Innes

For Arizona, the cancellation of nearly $190 million in federal grants marks a severe blow to efforts to safeguard public health. ADHS received notification that several critical grants were being cut, effective March 24, 2025.

It’s still unclear exactly which entities are being cut and by how much – the $190M in cuts represented investments in public health and PH infrastructure among more than 269 contracts with local organizations, all 15 county health departments, several Tribal health departments, and university partners.

Mohave County health programs hit by loss of federal funding | 12news | Resnick

Specific cuts included the CDC Health Disparities Grant, sub-grants tied to the Vaccines for Children Program, and sub-grants within the Epidemiology Laboratory Capacity Grant—all of which focused on improving disease surveillance, response capabilities, and public health infrastructure across Arizona.

Trump cancels billions in health grants, hitting local efforts hard

These cuts aren’t just numbers; they’re a direct assault on Arizona’s ability to respond to emerging infectious diseases and protect the public’s health.

The affected grants had funded crucial programs designed to bolster the state’s disease detection, prevention, and control efforts. Local organizations—ranging from the 15 county health departments to tribal health centers and universities—were all relying on this funding to carry out projects aimed at monitoring and responding to public health threats.

Among the alarming cuts are an immediate end to improving the effectiveness of MEDSIS (the state’s disease case surveillance system) – Arizona’s tool for monitoring and coordinating the response to disease cases and outbreaks.

Arizona public health agencies losing $190M in federal grants | 12news.com

Without the funding now gone, Arizona’s public health infrastructure further behind in the fight against future outbreaks. As communicable diseases continue to evolve, this system would have played a critical role in tracking trends and ensuring timely responses.

The loss of these funds effectively halts Arizona’s efforts to improve its disease surveillance capabilities.

Other initiatives funded by the now deceased grants were filling response holes by supporting local health departments and providing tools for better disease control. With the termination of these funds, projects that were on track and compliant with grant requirements will now come to a standstill, leaving local health agencies without crucial resources.

The impact of these cuts will be far-reaching. Arizona’s public health infrastructure will be  weakened and Arizona’s ability to respond to health emergencies undermined.

Kennedy’s move is part of a larger strategy that seems intent on dismantling essential public health functions at the federal, state and local level. While his push to refocus on chronic diseases has some merit, the immediate effects of these funding cuts suggest that the true cost will be the loss of crucial resources and infrastructure that protects the health and safety of all Arizonans.

In short, the termination of these grants marks a big blow to Arizona’s public health system. With vital programs cut and surveillance tools stalled, the state will be ill-equipped to face future health crises. These changes are not just a setback—they are a direct threat to public health and well-being in Arizona.

Editorial Note: I wish I had better news – and my intent isn’t to bum all of you out – but it’s important to see things with a clear eye so we can collectively do the best we can to weather the public health storm we’re facing together.

Arizona is one of 23 states plus the District of Columbia

Kennedy Begins Disassembling the U.S. Public Health System

HHS Secretary Kennedy unveiled a sweeping plan this week that will substantially dismantle the nation’s public health infrastructure. His announcement signals a drastic shift in HHS’ decades long approach to evidence-based public health, with major consequences for CDC, FDA, HRSA, CMS, IHS and the NIH. Kennedy’s decisions this week included a wholesale firing at those HHS agencies.

Kennedy used a two-pronged approach to disassembling public health infrastructure: massive budget cuts for state and county health departments, as well as laying off thousands of employees across various HHS agencies.

These actions are just the first step in what is expected to be a broader effort to reduce the federal government’s role in public health and health regulation.

One element of Kennedy’s plan to fire staff includes closing several HHS regional offices, including the one in San Francisco, which serves Arizona. These closures, including the relocation of services to other cities like Denver are less about operational efficiency and more about encouraging current staff to quit rather than uproot their lives and families.

In essence, these closures could force employees to make difficult decisions about their careers, further reducing the government’s investment in public health infrastructure.

The implications for Arizona are significant. The HHS regional office in San Francisco plays a crucial role in overseeing public health efforts in the state, especially in terms of grant funding and accountability.

Trump plan for overhauling health agencies will cut 10,000 positions | Science | AAAS

As a primary function of many positions within these agencies, project officers are tasked with overseeing the use of federal funds at the state and local levels. These positions ensure that state and local health departments are held accountable for how they use the grants they receive, reinforcing transparency and responsible allocation of resources.

Kennedy’s decision to cut these positions is not just a cost-saving measure; it is a direct attack on accountability.

Without project officers overseeing the spending of federal funds, Arizona’s state and local health departments lose important guidance and oversight. This erosion of accountability isn’t about streamlining operations; it’s part of a broader effort to disassemble the health sector’s regulatory framework.

By reducing the staff that holds local agencies accountable, Kennedy’s plan undermines the very mechanisms that ensure public health policies are effectively implemented, and funds are used appropriately.

Kennedy to cut 10,000 jobs at Health and Human Services

This announcement is likely only the beginning. We can expect further reductions in public health infrastructure and services. These cuts will affect Arizona’s health agencies to respond to emerging health threats, both chronic and infectious. As federal oversight and resources dwindle, the state will be left to fend for itself, with fewer tools and less guidance from the federal government.

Secretary Kennedy’s announcement marks a turning point in the federal government’s approach to public health. While his focus on chronic diseases may have some merit, the dismantling of critical public health infrastructure poses a serious threat to public health systems across the United States, including in Arizona.

By cutting staff, reducing oversight, and closing regional offices, Kennedy’s plan undermines the very framework that ensures public health efforts are effective and accountable.

These changes are likely just the first step in a larger, more destructive overhaul of the nation’s health system, and the consequences will be felt for years to come.