Will Humble Healthcare, Public Health, Return on Investment, Wills Blog

From Lab Bench to Treatment: Why NIH Funding Matters for New Cancer Treatments

When people hear about breakthrough cancer treatment in a statement from a drug company it might seem can sound like they suddenly invented something amazing. That’s usually not how it works.

Most new treatments start with basic research funded by the NIH and the National Cancer Institute. That early funding helps scientists learn how diseases work and test new ideas long before any company is ready to spend big money.

mRNA technology is a good example. The science behind it was built over many years with public support, long before it became a household term.

Now look at pancreatic cancer. A personalized mRNA treatment called autogene cevumeran is being evaluated after surgery in patients with pancreatic cancer. The idea is to train the immune system to spot and attack any cancer cells left behind.

Early (Phase 1) results were promising enough that the work moved into a larger global Phase 2 trial sponsored by Genentech in collaboration with BioNTech (which is underway with hundreds of patients right now).

That’s the pattern we see again and again: public funding helps build the platform; private industry funds the bigger trials needed to bring treatments to market.

And here’s the twist. Kennedy is openly hostile to mRNA technology, and he ended federal support for mRNA-related projects.

The good news is that the earlier basic research found this technology has potential applications for a host of cancer treatments, including for post-surgery pancreatic cancer.

The results found from decades of public investment that already helped launch mRNA into cancer research means that Kennedy won’t be able to single-handedly kill these new therapies. Even if new mRNA cancer treatments make it through their clinical trials and Kennedy directs the FDA to not license the therapy because of his confirmation bias mentality – he will be gone in 2.5 years.

And one more thing…  if the pancreatic cancer trials pan out, a lot of MAHA people who spent years attacking mRNA may suddenly decide they’re very much in favor of it (or pretend they were never against the technology).

Note: In an ominous twist this week, the president dismissed all members of the National Science Board, the independent body that sets policy for the National Science Foundation and advises Congress and the president on science and education.

2024 ballot propositions

Will Humble Medicaid, Wills Blog

AHCCCS 101 Series: What We Covered

Over the last month, we took a deep dive into Arizona’s Medicaid program… the Arizona Health Care Cost Containment System (AHCCCS). It’s a $20+ billion system that covers more than 2 million Arizonans and runs very differently than most state Medicaid programs.

If you missed any part of the series, here’s the full rundown—and why it matters for public health policy right now.

Part 1: Why Arizona Built Medicaid Differently

https://azpha.org/2026/04/07/ahcccs-101-part-1-of-4-ahcccs-origin-story-why-arizona-built-medicaid-different/

Arizona was the last state to adopt Medicaid—but when it did in 1982, it skipped the traditional fee-for-service model and went straight to managed care. That decision still defines AHCCCS today. Instead of paying providers directly for each service, the state pays health plans a set amount per member to manage care.

That structure has made AHCCCS one of the most cost-controlled Medicaid programs in the country—but it also means everything hinges on contracts and oversight.

Part 2: Who Really Makes the Decisions

https://azpha.org/2026/04/14/ahcccs-101-part-2-waivers-state-plan-amendments-and-who-decides/

AHCCCS doesn’t work in a vacuum. Federal law sets the guardrails, but states have flexibility through tools like 1115 waivers and State Plan Amendments.

This part unpacked a key reality: innovation (like housing supports or community-based services) only happens when AHCCCS designs it and CMS approves it. That shared authority shapes what’s possible—and how fast change happens.

Part 3: Contracts, Accountability, and Performance

https://azpha.org/2026/04/21/ahcccs-101-part-3-contract-management-accountability/

Because AHCCCS is fully managed care, contracts are the backbone of the system. Health plans handle delivering care, meeting quality benchmarks, and managing costs.

We walked through how AHCCCS uses tools like performance metrics, financial penalties, and quality standards (HEDIS, ACOM) to hold plans accountable.

Bottom line: If the contracts are strong and enforced, the system works. If not, outcomes suffer.

Part 4: From Coverage to Care – The Member Experience

https://azpha.org/2026/04/29/ahcccs-101-part-4-from-coverage-to-care-the-member-experience/

Coverage doesn’t automatically mean care. This final piece focused on what it’s actually like to navigate AHCCCS.

From plan choice (or auto-assignment) to provider networks to the well-known frustrations with Health-e-Arizona Plus, the member experience can be uneven—especially for people with complex needs like serious mental illness or long-term care.

The Bottom Line

AHCCCS is the healthcare system for low-income residents and people with disabilities covering everything from primary care to behavioral health services to home and community-based services for folks with developmental and intellectual disabilities.

The managed care model is both the program’s strength and its risk. Federal-state dynamics shape what Arizona can and can’t do. Contracts and oversight determine whether the system delivers results. And the member experience is where policy either succeeds or fails.

Note:  AHCCCS has a new Online Provider Directory that lets members get daily‑updated data and flexible search options by name, provider type, specialty, or location in the AHCCCS networks.

Will Humble Social Determinants, Wills Blog

By This Time Next Week It’ll be a Crime to Provide Humanitarian Aid in Phoenix City Parks

By this time next week, handing someone a sandwich, a pair of socks, or basic wound care in a Phoenix park will be a crime (a Class 1 misdemeanor – the worst kind).

Phoenix Imposes Criminal Penalties for Providing ‘Street Medicine’ in Parks without the Parks Director’s Permission

The hearing will be on June 6 at 2:30pm. It will likely be performative on the part of the Council.

The brainchildren for proposing this cruel ordinance are recently promoted former Parks Department Manager (and now Deputy City Manager) Cynthia Aguilar and City Manager Ed Zuercher (who makes $415,542 per year).

The proposed ordinance would make it illegal to provide medical care or distribute food in city parks without a permit. On paper, it creates a narrow pathway for very limited opportunities to provide very limited aid if an organization applies for and gets a permit to do so.

But, even if the Parks Department lets them do it (they won’t) it’s limited to just 2 events per month total, very limited time windows, and restrictions like making them set up a tent in a parking lot (which the city staff probably won’t let them do anyway).

In practice, folks who’ve worked with the Parks Department know those permits won’t be issued in any meaningful way.

Organizations like Phoenix Street Medicine, Circle the City, and others have been doing quiet, essential work for years…  things like basic wound care, hygiene supplies, food, connection to services will need to stop or face jail time and fines (6 months in jail and a fine of $2,500 plus court surcharges).

Even with a permit (that won’t be issued), the proposal completely bans syringe services and any care involving needles. Naloxone for overdose reversal appears to remain allowed but only in emergencies.

There’s also a requirement that any approved services be provided from a “shelter” placed on pavement. Again, something the city is unlikely to approve.

I’ve now heard from multiple people who’ve met with Mayor Kate Gallego that, while she listened politely, they all left thinking the decision is a locked in ‘yes’.

And if you’ve watched the Phoenix City Council over time, you know the pattern: proposals from City Manager and Parks leadership tend to get rubber stamped with minimal resistance once they’re on the Council agenda.

We can expect one “no” vote (Councilmember Anna Hernandez). There will be lots of public comment (including ours) that will be ignored, and the Council will pass this. Just watch.

But that doesn’t mean our opposition is meaningless. Even when the outcome is locked in, the public record matters. Silence gets interpreted as consent… and we will be putting in comments to make it clear we object.

If you’re inclined, send a comment or sign up to speak:

https://www.phoenix.gov/administration/departments/cityclerk/programs-services/city-council-meetings.html

You can also review the ordinance itself:

https://www.phoenix.gov/administration/departments/parks/about-us/medical-treatment-and-food-distribution-in-parks.html#new-proposed-ordinance

And here’s more reporting for context:

https://www.phoenixnewtimes.com/news/phoenix-may-ban-handing-out-drug-testing-kits-city-parks-40629434/

When you make basic humanitarian aid a crime, you don’t solve homelessness, you simply kick them in the teeth.

Will Humble State Legislature, Wills Blog

State House of Representative Passes a Fake Budget: Senate to Approve it this Week (Followed by a Veto)

Then the Real Negotiations Begin

Last week House and Senate Republicans rolled out and had hearings on mirror-image budget proposals. The House version passed last week. The identical Senate version will pass this week – followed by a prompt veto.

Then then the real budget negotiations will begin.

This initial budget emphasizes tax cuts, spending reductions (especially agency budget cuts). Dems highlight potential impacts on healthcare coverage, food aid, and core services.

Normally I’d include a link to the budget the House passed here – but I’ll refrain as it is DOA on the 9th floor.

For now, nearly all policy bills (including those related to public health and healthcare) are in suspended animation.

That includes the bills we’ve been weighing in on this session. For a refresher on where things stood heading into this phase just click on our blog post from earlier in April (not much has changed since then):

https://azpha.org/2026/03/29/legislative-session-summary-committee-deadlines-hit-floor-action-accelerates-and-budget-negotiations-start/

In the meantime, a budget compromise will eventually appear, and they’ll finish the session in a blaze of late-night sessions, probably in May sometime.

Note: It’s during those late-night sessions that the Republicans will decide which of the many ballot propositions they will place on the November ballot. I’m certain there will be at least a few that relate directly to public health and healthcare (for the bad). There are also a couple of voter initiatives that are collecting signatures that will affect public health – or public health adjacent stuff like voting rights.

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