Will Humble Air Quality, Climate Change, Public Health

More Federal Red Tape for Renewables

The old conservative movement used to say government should let markets guide investment decisions. Companies should decide where to invest based on cost, demand, and what works best. Government should stay out of the way and avoid picking winners and losers.

The populist movement now running the federal government has scrapped that approach in favor of using policy and bureaucracy to steer private investment away from wind and solar and toward fossil fuels.

A new Wood Mackenzie analysis, Federal friction: permitting risk across the U.S. utility-scale renewables pipeline found that federal agency actions have put 92 gigawatts of large-scale solar, wind, and battery-storage projects under added permitting burdens to slow them down or stop them. Those projects represent more than $121B in clean-energy investment.

Federal friction : permitting risk across the US utility-scale renewable pipeline Report | Wood Mackenzie

Their goal is to stop the development of renewable-energy projects, even when they may be among the least expensive ways to generate electricity.

The report also found that new permitting barriers and the withdrawal of federal funding contributed to the cancellation of 7 gigawatts of clean-energy projects on federal lands in 2025.

One example is a July 2025 Interior Department memo. It requires nearly every federal action involving wind and solar projects to go through a new, multi-step review process. The process ends at the Secretary of the Interior’s office. That means more paperwork and uncertainty for businesses that want to build solar, wind, or battery projects.

Departmental Review Procedures for Decisions, Actions, Consultations, and Other Undertakings Related to Wind and Solar Energy Facilities

The Interior Department is using special “emergency procedures” to speed up permits for oil, methane, and coal projects.

That’s government picking winners and losers.

According to Wood Mackenzie, about 30% of planned solar development is now facing added Interior Department review.

Wind is being hit even harder, with 62% of planned wind development on federal lands subject to extra review.

Arizona is one of the states most exposed to these new federal barriers, behind only Texas and California.

We have some of the best solar resources in the country. Our electricity demand is growing quickly, especially during extreme summer heat. Solar, battery storage, and other clean-energy resources can help meet that demand while reducing dependence on volatile fossil-fuel markets.

Arizona families will pay the price through higher energy costs, fewer local investments, and fewer clean-energy jobs.

Elections matter. Remember that in November.

Will Humble Air Quality, Climate Change, Public Health

Arizona’s Clean Energy & Energy-efficiency Rules Worked. They Should’ve Been Updated, Not Repealed

The Arizona Corporation Commission has now repealed both of Arizona’s major electric clean-energy rules: the Renewable Energy Standard and Tariff (REST) rules and the Electric Energy Efficiency Standards (EEE) rules.

REST was repealed on March 4, 2026. They repealed the energy efficiency standards last Wednesday.

That means the Commission has now eliminated both sides of Arizona’s clean-energy / energy-efficiency policies: one that pushed utilities to generate more electricity from renewable resources and the other which incentivized utilities to help customers use less electricity in the first place.

Renewable Energy

Arizona’s REST rules were adopted by the Commission back in 2006 when there were actually Commissioners in place that weren’t captured by the utilities. Those former rules required ACC-regulated electricity utilities to increase the amount of renewable energy in their portfolios, ultimately reaching 15% of retail electricity sales from eligible renewable resources by 2025.

Utilities used renewable energy credits to track compliance and were required to file annual plans explaining how they would meet the standard. REST helped push Arizona utilities toward solar, wind, and rooftop generation sources for nearly two decades.

In other words, REST told regulated utilities that renewable energy was required and held them accountable for achieving results.

It worked.

Arizona utilities met the goal a couple of years ago. But instead of updating the rules to incentivize more renewable generation, the ACC’s scrapped the renewable energy standards altogether last March.

The captured Commission’s argument was that REST was outdated because utilities had already met the goal. I see it differently.

The fact that utilities met the goal is evidence that the policy worked. The next logical step should have been to update the standard with a new goal, not throw the whole thing away.

AzPHA submitted formal comments urging the Commission back in March to update rather than repeal REST. We recommended requiring regulated utilities to get at least 25% of their electricity from renewable energy by 2035.

The Commission voted unanimously to repeal the REST standards anyway.

Energy Efficiency

Getting rid of incentives to develop more renewable energy in their portfolios wasn’t enough for the Commission. They wanted to go further and get rid of the energy efficiency incentives too… so last week they voted 4–0 to repeal Arizona’s Electric Energy Efficiency Standards rules (the EEE rules).

EEE was the demand-side companion to REST.  REST focused on where electricity comes from. EEE focused on how much electricity homes and businesses use and when they use it. By the way, energy efficiency is far and away the cheapest form of energy.

The EEE rules were adopted in 2010 and made ACC regulated power companies achieve peak-demand reductions via cost-effective energy efficiency, load management, and demand-response programs. The target was a cumulative 22% energy-savings goal by 2020.

EEE helped support utility programs that encouraged customers to reduce energy use, upgrade appliances, improve building efficiency, shift demand away from peak hours, and reduce strain on the grid.

Energy efficiency is the cheapest resource available. The cleanest and least expensive power plant is the one you don’t have to build because customers are using less power in the first place.

The ACC’s repeal of the EEE standard last week doesn’t eliminate every existing energy-efficiency or demand-response program. APS can still propose those programs, and the Commission can still approve them case by case.

But, I’ll bet you dollars to doughnuts APS will abandon all of it in favor of just building more and more methane generation plants (especially if they get their new rates approved and the higher return on equity demand – which they will get).

The Political Problem

Arizona’s utility watchdog is now basically the utilities’ guard dog.

REST and EEE did different things, but they worked together. REST pushed utilities to build cleaner electricity supply. EEE pushed utilities to reduce demand and manage peak load. One policy focused on generation. The other focused on conservation. Both were part of a practical clean-energy strategy.

Both are now gone.

The Commission should have modernized both rules. For REST, that could have meant a new renewable-energy target paired with stronger planning for storage and grid reliability.

For EEE, that could have meant a modernized efficiency standard focused on peak-demand reduction, low-income household benefits, weatherization, smart thermostats, demand response, and cost-effective building upgrades.

Instead, the ACC repealed both. REST ended March 4. EEE ended July 8.

Arizona now has less clean-energy accountability, less long-term certainty, and more dependence on case-by-case utility proposals and the political leanings of the Commission.

Our comments to the Commission on both of these important policies didn’t work (nor did I think they would work).

But at least we were part of the process, and at least the public record now includes a clear argument for why Arizona should update successful clean-energy rules (on both the supply and demand side) rather than repealing them.

Read AzPHA’s comments on the REST Rule Here

Read AZPHA’s comments on the EEE Rules Here

Will Humble Professional Development, Wills Blog

Public Health Students: Get Real-World Public Health Practice Experience

The Maricopa County Department of Public Health Internship Program is now accepting applications for fall internships. The internships connect what students learn in class with what public health work actually looks like in the real world.

Interns get meaningful project experience, professional mentoring, leadership development, and an inside look at how a large local health department works to improve health across the community.

It’s also a chance to start buildiong a public health career, build practical skills, make professional connections, and stand out when applying for public health jobs after graduation.

As a Public Health Intern, students will participate in three core parts of the program:

Interns work directly with a specific office or program within the health department on day-to-day project-based work that supports MCDPH’s public health mission.

Students will:

  • Work on a mission-driven project that strengthens their résumé
  • Get one-on-one mentorship from a public health professional
  • See how government public health operates behind the scenes
  • Gain experience that helps distinguish them from other candidates when applying for career-level public health positions

A strong academic record matters… I know from first hand public health practice that employers also want candidates who understand the work, can contribute on a team, and have demonstrated they go above and beyond. 

This internship is a chance to start building that track record now.

Apply for the MCDPH Public Health Intern Program Here

Process Step Estimated Timing
Positions Post Wednesday, July 1, 2026
Applications Close Sunday, July 19, 2026
Final Interview Deadline Friday, August 7, 2026
Confirmation to accept position, if offered Wednesday, August 12, 2026
First Day of Internship Wednesday, August 26, 2026
Final Day of Internship Wednesday, November 25, 2026
Will Humble Climate Change, Environmental Health, Social Determinants, Wills Blog

APS Wants Yet Another Giant Rate Increase. Will the Corporation Commission Have Our Back or the Monopoly’s Back?

Arizona Public Service is a monopoly utility. If you live in the APS area you can’t shop around for another electricity company. You have one choice: pay APS what they say you owe or go without power.

The Arizona Constitution gave the AZ Corporation Commission the power to regulate monopoly utilities for that reason. The Commission is supposed to act in the public’s interest. It’s supposed to make sure that captive ratepayers are charged fair and reasonable rates while utilities have enough money to provide safe and reliable service.

Or at least that was the intent…. but it hasn’t been working out that way for a long time now because the elected ACC commissioners have been rubber-stamping APS rate increase requests.

APS is now asking the Commission to approve yet another unreasonably large rate increase. Its original request was for a 14% increase. After filing rebuttal testimony this spring, APS raised its request to nearly 15%.

That comes after the APS rate increase that took effect in 2024, which raised the typical residential bill by about 8%.

APS is even demanding an even higher allowed return on equity…  which is the profit rate the company is guaranteed to earn for its shareholders.

APS is asking for a whopping 10.7% return on equity (their current authorized return is already a whopping 9.55%).

The allowed return on equity is one of the most important parts of a rate case. It directly affects how much ratepayers must pay each year. It also would let them ask for (demand) even higher rate increases in the future.

How Much Profit Is Enough?

APS and its parent company, Pinnacle West, aren’t struggling financially. Not by a long shot. You might say that right now, given who is on the Commission, they’re living high on the hog (and so are their shareholders).

Pinnacle West reported more than $616M in net income for 2025. Its current CEO got compensation of about $8.4M that year. The former CEO got $2.8M in total compensation. That’s your money.

How much money does APS really need from Arizona families in order to provide reliable service and attract the investment it needs?

Attorney General Kris Mayes (who used to be a commissioner) filed expert testimony arguing that APS’s proposed increase could be cut from about 14% to about 3% while still allowing the company to keep reliable service and a strong credit rating.

APS and their leadership see it differently, of course. They argue that its current rates are based on older costs, that equipment and labor are more expensive, and that new data centers and major industrial customers require large investments in generating capacity. 

The ACC’s job is supposed to carefully examine APS’s claims, review the evidence, and decide which costs are justified and which costs shouldn’t be passed on to ordinary ratepayers.

Their track record over the last few years suggests they’ll approve of whatever the monopoly wants.

APS Also Wants Formula Rates

But wait, there’s more. APS isn’t just asking for a giant rate increase and a boost in their return on equity. They also want automatic rate increases via a ‘formula’ rate plan.

Under the traditional system, they file a rate case when they want to boost their rates. The ACC process includes testimony, public comment, documents, cross-examination, an Administrative Law Judge recommendation followed by a final public vote by Commissioners.

APS’s formula-rate proposal creates annual automatic rate increases using a formula. In other words, they’ll get automatic rate increases in the future and avoid the normal hearings and even ACC votes.

Energy Choices Matter Too

This rate case is also happening as APS changes its long-term energy plans.

In 2020, APS committed to providing 100% clean, carbon-free electricity by 2050. It also set interim goals for 2030 and said it would end coal-fired generation by 2031.

They’ve since thrown all that out the window.

Last summer, APS ended those commitments and shifted its 2050 target from zero-carbon electricity to carbon neutrality. APS also joined other Arizona utilities in backing a major new natural-gas pipeline project that would bring gas from West Texas to Arizona.

Long-term investments in gas infrastructure, power plants, transmission, and fuel contracts can affect customer bills for decades. They can also affect air quality, climate risks, and the health impacts of extreme heat.

What Happens Next?

The formal evidentiary hearing in the APS rate case is now underway. APS, ACC staff, the Attorney General’s Office, consumer advocates, businesses, and other intervenors are presenting evidence to the Administrative Law Judge.

After the hearing the judge will prepare a Recommended Opinion and Order (although that’s a bit of a misnomer because it’s not really an Order but more of a recommendation to the Commissioners).

The final decision from the ACC will come later this year (probably after the election but before the next set of Commissioners are seated).

Corporation Commission elections more important than most voters realize. The commissioners elected to those seats decide whether monopoly utilities are held accountable to ratepayers or whether customers are expected to pay whatever the utility says they have to pay.

Rate increases, higher return on equity levels which feed increased rates, future automatic rate increases and scrapping of clean energy goals and of course public health are all on the ballot in the ACC races. Pay attention!

 

Note REST Rule Comments here

Will Humble Uncategorized

Arizona Joins Lawsuit Challenging CMS’ Medicaid Work-Requirement Rule

Arizona joined 24 other states in a federal lawsuit challenging parts of the new (Interim Final) Medicaid “community engagement” rule issued by HHS and CMS earlier this month that fleshes out what they believe is required under HR1 with respect to work and community engagement requirements.

The lawsuit was filed in federal court in Massachusetts by Attorney General Kris Mayes and the other plaintiffs. It targets the Interim Final Rule CMS issued to implement H.R. 1’s new Medicaid work and community-engagement requirements.

See the Arizona et.al. v. Oz Complaint
CMS Finally Defines What Counts Toward Their New Work Requirements – AZ Public Health Association

The lawsuit doesn’t challenge the basic H.R. 1 law requiring many adults in the Medicaid expansion population to document 80 hours per month of work, school, job training, volunteer activity, or similar qualifying activities.

Rather, the suit challenges the way CMS went about the rulemaking and argues that the contents of the new CMS rule went beyond what Congress wrote in H.R. 1. In other words, that CMS exceeded their statutory authority.

The biggest complaint is about how CMS defined the exemption for people who are “medically frail” or have special medical needs. H.R. 1 (the statute) specifically excludes people with serious or complex health conditions, substance-use disorders, disabling mental-health conditions, and certain disabilities from the work requirement.

But CMS’ rule says a person’s condition also has to “significantly impair” their ability to meet the work requirement before they can qualify for the exemption. The suit argues that CMS added that extra test even though Congress didn’t put it in the law.

For example – under the new CMS rule, a person getting chemo could be forced to prove not only that they’re sick (e.g. medically frail because of the chemo), but that it significantly impairs their ability to meet the requirement. That’s just an example – but you get the idea.

The suit also says the new CMS Rule inappropriately limits states’ ability to use existing data and self-attestation to determine who is exempt. It argues that the rule creates confusing and contradictory verification standards, restricts hardship and emergency protection, and gives states little time to rebuild their eligibility systems.

The real risk isn’t that hundreds of thousands of AHCCCS members are refusing to work or participate in their communities. The real risk is that people who are working, qualify for an exemption, or are medically frail will lose coverage because the notices are confusing, the paperwork is too hard, or the Health-e-Arizona Plus portal doesn’t work.

Finally, the suit says CMS violated the Administrative Procedure Act because it conflicts with H.R. 1 and the new rule is arbitrary and capricious in some areas.

It also argues that CMS violated the Constitution’s Spending Clause by imposing unclear, last-minute conditions on states that rely on federal Medicaid funding.

Arizona still needs to operate under the assumption that the CMS rules will remain in place, so they’re prepared for that eventuality. But there’s also a chance a judge might stay portions or all of the CMS rule in the coming weeks.

Stay tuned.

Will Humble Public Health, Public Health Law, Wills Blog

Action Alert: Federal Government Planning to Implement Political Litmus Tests for Federal Grants Across All Health Agencies

Comment Deadline July 12

Early in this administration, DOGE bros & political appointees (e.g. Kennedy)  canceled large numbers of federal research & service grants. The decisions were knee-jerk, ideological, and mostly unrelated to the purpose or quality of the work being funded.

Grants were often canceled because one of the DOGE bros or Kennedy thought a word in the scope of work was ‘woke’.

The lawsuits that followed overturned many of the DOGE/Kennedy sweeps. When judges overturned the cuts often did it because the federal agency (HHS) didn’t follow Office of Management and Budget (OMB) rules when they canceled the project. 

Now the feds are changing the OMB rules so they can summarily cancel grants without judges overturning their decision.

How?

By rewriting the OMB federal rules that govern grants, cooperative agreements across the executive branch to make it so they can do basically whatever the political appointees want. OMB is calling it the “Uniform Grants Regulation.” 

The new political criteria would (will) apply across the executive branch to dozens of agencies, including all the HHS agencies plus NIH, NSF, HUD, DOJ, FEMA, etc. OMB wants the final rule to take effect October 1, 2026.

Political Appointees Would Decide All

Under the already proposed rule, every discretionary grant would have to be approved by a political appointee before it could be awarded. The political appointee shall not defer to peer-review or expert recommendations.

The proposed rule instructs political appointees to make sure the grants advance the President’s policy priorities and that they can’t “promote anti-American values” (which is undefined).

The proposed rule even requires applicants to commit to what OMB calls the administration calls “Gold Standard Science”, which also doesn’t have an objective definition.

For decades, agencies like HHS and NIH have relied on independent experts to evaluate research proposals. They look at the question being asked, the quality of the methods, whether the work is likely to produce useful results, and whether the research team can do the job. Technical stuff.

All that would change once the OMB rules go into effect this fall. 

Grants Could Be Cancelled Mid-Project for Political Reasons

The proposed rule also gives federal agencies broad new authority to end a discretionary award during the middle of a project. A grant could be ended if an agency decides that it no longer advances agency priorities or “the national interest.”

No finding of fraud, waste, abuse, or noncompliance would be needed, just a finding by the political appointee (e.g. Kennedy) that she or he thinks the research isn’t in the national interest.

There would be no due process and there wouldn’t need to be an administrative hearing or appeal process.

For example, a university could hire researchers and staff, enroll study participants, build a data system, and begin a multi-year project, only to have a political appointee determine the project isn’t in the national interest.

Same with just about any other cooperative agreement with a state and the pass-through money that goes to county health.

States & Counties Would Become Federal Compliance Officers

As if that’s not enough… the rule basically deputizes states and counties to also follow the federal OMB rules and even apply them to their subrecipients.

State governments get lots of money that they then pass through to county health departments, universities, hospitals, and nonprofit organizations.

Under the proposal, the state and pass-through entities would have to build the federal conditions into their own subgrants.

Why Your Comments Matter

AzPHA submitted comments on the proposed rule already but ADHS, county health departments, universities, hospitals, and others should file comments too. Nonprofits too.  Your comments will be better than mine.

You can explain what grants you manage. Explain the people you serve. Explain what would happen if a project were cancelled halfway through.

Explain how political screening of research would affect your ability to recruit staff, plan programs, enroll participants, or partner with communities. Explain that the new rules give political appouintees like Kennedy to be arbitrary and capricious in their decision-making.

Reference the part of the proposed rule that concerns you. For example:

  • Section 200.205: political review of discretionary awards and peer review.
  • Section 200.206: expanded “risk” reviews, including organizational affiliations.
  • Section 200.300: new federal conditions flowing down to subrecipients.
  • Sections 200.340 through 200.343: termination, suspension, and limited due process.
  • Section 200.450: restrictions on issue advocacy and public messaging.

Comments are due by July 13, 2026, through Regulations.gov under docket OMB-2026-0034. Here’s the Link to comment: OMB-2026-0034 Regulations.gov

View AzPHA Comments on OMB 2026 0034 Grant Award Rule (Regulation for Financial Assistance) 

Suggestions for How to Comment on Federal Regulations

View the Proposed Rule: Federal Register: Regulation for Federal Financial Assistance

Your comments will become part of the public record. That’s important even if OMB ignores them. When this rule is challenged in court, your comments will matter.

Judges look at whether agencies considered real-world impacts, explained their choices, and acted reasonably under the law when they wrote the regulation.

 

Will Humble Climate Change, Public Health, Wills Blog

Saving Lives Through Heat Relief: Arizona’s Novel Approach – A Free Webinar

Friday July 10, 12:00pm – 1:00pm AZ-MST (PST)

Extreme heat is the deadliest weather threat in the Southwest — but Arizona is proving those deaths are preventable. Join the Arizona Public Health Association and the Health Insights Hub by Hess III Consulting for this free virtual Power Hour on July 10, 2026, featuring Maricopa County and Pima County Departments of Public Health, for a closer look at their novel, coordinated approaches to heat relief.

This session shows public health leaders, health and human services organizations, and community partners how cross-sector coordination saves lives — and how to adapt these strategies in your own community.

Register: Saving Lives Through Heat Relief, Arizona’s Novel Approach
Will Humble Social Determinants, Wills Blog

Housing Is Public Health: Congress Takes a Step Up… but the Real Work Is Still Local

Affordable housing (actually the lack of it) is one of the biggest public health issues in the US.

Where families live, how stable their housing is, and how much of their paycheck goes toward rent or a mortgage have a direct effect on physical health, mental health, food security, transportation, and access to medical care.

In fact, housing is the largest part of a low-income family’s budget. Electricity and food are close behind. For many families, there is no extra money left at the end of the month. That has a profound effect on the family’s physical and mental health.

The Core Problem: Supply & Demand

The basic problem isn’t complicated, but the solutions are.

There aren’t enough homes and apartments that working-class and low-income families can afford.  When demand for housing is higher than the supply, prices go up. Families compete for too few apartments, homes, and lots. Landlords and sellers have more leverage. The people with the least money have the fewest choices.

The result is financial stress, overcrowding, frequent moves, evictions, homelessness, and families being pushed farther away from jobs, schools, grocery stores, and health care.

Housing instability is linked with worse physical and mental health. Families that spend too much on housing have less money for food, utilities, transportation, and health care. That is not a political opinion. It is a basic public health fact.

The Biggest Housing Roadblock Is Local

A major reason we don’t have enough housing is local zoning and the NIMBY effect.

Getting Past NIMBY’s Chokehold on Housing – AZ Public Health Association

City governments often make it difficult or impossible to build apartments, townhomes, duplexes, accessory dwelling units, manufactured homes, or smaller starter homes in many neighborhoods. Existing homeowners have figured out how to put a chokehold on this kind of housing development.

That is the NIMBY problem: “not in my backyard.”

NIMBYism keeps the supply of housing supply low by locking in onerous and overly restrictive zoning ordinances. That drives prices up. It pushes workers farther from their jobs. It makes homelessness worse. And it helps create the affordability crisis we see today.

The problem is spread across thousands of local jurisdictions, which makes it politically difficult to solve. But that is also where much of the work must happen.

States & Congress Have Adjacent Roles

States can help by setting reasonable limits on exclusionary local zoning rules. They can make it easier to build duplexes, townhomes, accessory dwelling units, manufactured housing, and smaller homes near jobs, schools, and transportation. They can do that by essentially micromanaging cities and ‘preempting’ them keeping such a tight stranglehold on zoning laws.

The federal government can play a role too, but in a more indirect way.

Congress took a meaningful step in that direction this week when it passed the bipartisan 21st Century ROAD to Housing Act last week.

It’s not a cure for the housing crisis, but it can help some (if the president signs it). It won’t quickly lower rents or home prices. And it won’t overcome local zoning barriers that stop new housing from being built. But it’s a start.

What it Does

The federal housing bill includes several practical ideas that can help increase housing supply over time.

  • It makes it harder for large institutional investors to keep buying existing single-family homes. Institutional investors that already own at least 350 homes would face limits on buying additional single-family houses.
  • It removes outdated federal barriers to manufactured housing. Manufactured homes can be a lower-cost option for families, but federal rules and financing barriers have often made them harder and more expensive to build or buy than they should be.
  • It incentivizes state and local governments to modernize planning, permitting and zoning.
  • The legislation also makes changes to federal housing programs that help communities use existing resources more effectively, including for housing-related infrastructure and the conversion of vacant commercial or industrial buildings into housing.

Housing & the Immigration Crackdown)

There’s another less talked about part of this conversation that deserves more attention: labor.

We can’t build more inventory to balance the supply and demand equation without workers building homes.

Immigrant workers are a major part of the construction workforce. They’re framers, roofers, electricians, drywall installers, landscapers, painters, and concrete workers.

For the last 1.5 years our federal immigration policy and the behavior and decisions by ICE around mass deportation and punitive enforcement make the housing shortage worse. It shrinks the labor pool, delays projects, raises construction costs, and makes it harder to build homes that working families can afford.

So honestly it could be that even if the president signs 21st Century ROAD to Housing Act – it may not even counteract the punitive immigration policies they’re implementing that are dramatically shrinking the construction labor pool.

A Helpful Start—But Not the Finish Line

As I write this the President still hasn’t signed the bill. He canceled a planned signing event on June 24. Hopefully, the bill becomes law soon.

This legislation will help around the edges and create useful incentives for reform. But the biggest barriers are still local land-use rules, neighborhood opposition to new housing, high development costs, limited construction labor, all of which results in a lack of enough homes for people with low and moderate incomes.

The Bottom Line

In order to fix the affordable housing crisis cities need to stop treating every new housing proposal as a threat to existing homeowners.

States need to keep pressure on local governments that refuse to allow enough housing.

The federal government needs to stop pursuing immigration policies that make it harder and more expensive to find the workers needed to build homes.

We’re not going to lower housing costs without building more housing. And we are not going to build more housing unless policymakers at every level are willing to take on the political forces that benefit from keeping supply low.

Will Humble State Legislature, Wills Blog

Arizona’s 2026 Legislative Session: A Summary (& PowerPoint)

2026 AZ Legislative Session: A Public Health Perspective (ppt)

2026 AZ Ballot Propositions: A Public Health Perspective (ppt)

Arizona’s 2026 legislative session is in the books. From a public health perspective, there were some important wins, several bad things were stopped or vetoed, and of course there were lots of missed opportunities. They also out some bad stuff on the November ballot.

The Bills

There were a few bills that passed and were signed that will (or should) improve health-care facility licensing and nursing-home and assisted living oversight.

Several behavioral health bills also made it through. County jails will now be required to screen people for mental health needs and provide further assessment and treatment.  Other new laws will improve the court-ordered evaluation and treatment process. That’s important because better COE and COT can prevent people with serious mental illness end up cycling through jails, emergency rooms, and the courts instead of getting the care they need.

Other good bills restored AHCCCS waiver requests for tribal members, required state-agency chief medical officers to hold an active Arizona medical license, and removed health insurance co-pays for breast-cancer screening.

The governor also vetoed a lot of bad stuff.

She vetoed bills that would have interfered with vaccination, limited basic infection-control options for employers and health-care facilities. She also vetoed proposals that would have added unnecessary red tape to food assistance or required hospitals to collect immigration-status information from patients.

The Budget

The final state budget also included about $21M for new eligibility staff at AHCCCS and DES, plus $12.9M to improve the Health-e-Arizona Plus computer system. That money is badly needed as new federal Medicaid work requirements and more frequent eligibility checks approach.

The State Budget Was the First Step Now Comes the Hard Part

The Propositions

Finally, they sent at least 3 bad propositions to the ballot. 1) Restrictions on voting by mail; 2) A measure that undercuts the ESA accountability voter initiative; and 3) A ban on photo-enforcement systems that would also threaten red-light cameras.

One of the biggest public health victories may be what didn’t pass. HCR 2056, the so-called “right to refuse medical mandates” constitutional amendment died. It would have weakened school vaccination requirements and made it much harder to control outbreaks of infectious disease. 

Will Humble Public Health, Wills Blog

Rural Health Transformation Funds & Bids  to be Announced this Week?

Rural AZ will be facing the hardest effects of the federal Medicaid cuts included in H.R. 1. Over the next few years.

The new law will make it harder for many people to stay enrolled in Medicaid. Starting in January about 500,000 people in the “Medicaid expansion” population will need to prove they’re meeting work or community-engagement requirements.

Congress’ Proposed Medicaid Cuts & Kennedy’s Separate IED: How Arizona Could Lose AHCCCS Coverage for 600,000 Residents – AZ Public Health Association

Expansion members will also need to renew their eligibility every six months instead of once a year. On top of that, changes to provider assessments and state-directed payments will reduce the money Arizona can use to support its Medicaid system in coming years.

Medicaid plays a much larger role in rural communities than in metro Phoenix and Tucson. Rural hospitals, clinics, nursing facilities, behavioral health providers, ambulance services, and maternity care programs depend heavily on Medicaid revenue.

In some parts of rural Arizona more than 40% of residents are covered by AHCCCS. Rural hospitals often have fewer privately insured patients to help make up for Medicaid losses.

That matters because rural health care is already under strain. Rural residents often live far from hospitals, specialists, labor and delivery services, and behavioral health providers. Nearly half of rural Arizona women must travel more than 30 minutes for maternal care. Some rural areas have only one behavioral health provider for every 50,000 residents.

Congress created the Rural Health Transformation Program partly because they knew their Medicaid cuts will hurt rural communities (often their ‘base’ supporters).  So, they created the Rural Health Transformation Program to distribute $50M over the next 5 years for rural healthcare ‘transformation’.

Arizona got $167M for this first year. It’s supposed to help rural communities strengthen their health care systems, workforce, technology, and access to care.

Arizona’s program is being administered by AHCCCS, collaborating with the Governor’s Office of Economic Opportunity and the Arizona Department of Health Services to a lesser extent.

Workforce Development

About $43M per year is planned for rural workforce development. This includes rural education and training, residency support, financial incentives for health professionals who work in rural areas, and stronger pipelines beginning in high school and continuing through colleges, universities, and clinical training programs.

Health Initiatives

About $31M per year is planned for priority health initiatives like behavioral health and substance-use services, maternal and fetal health, chronic disease prevention, community health workers, community health representatives, and rural EMS workforce development.

ADHS has identified maternal emergency readiness, perinatal mental health, congenital syphilis prevention, rural chronic disease screening, CPR and AED access, and rural EMS training as key priorities.

Health Care Accessibility

$38M per year is planned to make rural health care more accessible via telehealth hubs, remote patient monitoring, mobile clinics, satellite care sites, digital infrastructure, and better care coordination. T

Health Care Systems

About $38 million per year is planned for medical equipment, technology upgrades, electronic health records, data sharing, shared-service models, and technical help for rural providers trying to improve their operations and financial stability.

Getting the Money in the Field

Earlier timelines suggested that funding opportunities would begin in April or May. In early June, AHCCCS issued an updated timeline saying funding opportunities would begin in June and continue through the fall.

Awards are supposed to begin on a rolling basis. All first-year money must be obligated by October 30, 2026, and awardees will have until September 30, 2027, to spend it.

As I write this on June 25 the state’s public RHTP websites still don’t list the expected notices of funding opportunity or requests for proposals. The sites continue to say grant opportunities are coming in spring, and awards will be finalized by summer.

AHCCCS AZ Rural Health Transformation Program (RHTP)

Gov’s Office of Economic Opportunity (general website – no RHTP web page is available

The state has a lot of work to do before it can responsibly distribute that much money – and getting it right is more important that doing it fast.

Nevertheless, tribal health programs, community health centers, local health departments, colleges, universities, nonprofits, and other community partners are all chomping at the bit to get more info so they can plan for their responses to the grant notices.

Will the awards and notices come out next week as promised?

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