ICYMI: Arizona’s Medicaid program guarantees health coverage to birthing parents for just 60 days after pregnancy. For too many new parents in our state, the care they need to form a healthy bond simply isn’t there.

Parents without access to quality, affordable health coverage are likely to delay or decline treatment for their medical and emotional needs. Even minor conditions can become life-threatening or fatal without intervention – a reality reflected in Arizona’s high rate of preventable mortality and morbidity for pregnant and postpartum individuals. For Black, Indigenous, and People of Color who give birth in Arizona, the risks associated with pregnancy are even greater.

We’re urging lawmakers to prioritize a full year of postpartum Medicaid coverage in the state budget.** We need your help to amplify the message.

P.S. Have you checked our full list of 2022 legislative priorities?

Click here to send a digital note to your lawmakers

Having access to affordable, high-quality health care can make all the difference for a child. Kids with health insurance miss fewer days of school, get better grades, and are more likely to graduate from high school. Pregnant people who were covered by Medicaid and CHIP in their own childhood give birth to healthier infants than their peers who did not have health insurance.

In short, investing in access to health care can help families build a healthy economic future for generations to come.

The 2021 American Rescue Plan Act (ARPA) made critical investments in health care affordability, which we’ve detailed in a new report entitled “Acting on Affordable Care: The American Rescue Plan’s Role in Arizona’s Path to Pandemic Recovery.” But, as we note in the report - it’s up to Arizona’s Congressional delegation to solidify these changes, and up to state lawmakers to take full advantage of the flexibilities offered under the ARPA.

Please write Senators Sinema and Kelly and urge them to pass the Build Back Better package before the new year.

We need our state legislature to make sure that Arizona families can access the health care they need in 2022 and beyond.

1. Extend postpartum AHCCCS coverage to a full twelve months after pregnancy. This is a low-cost intervention that will help save lives and prevent severe illness, particularly among people of color.CLICK HERE to send a postcard to your state lawmaker stressing the importance of this issue.
2. Make KidsCare more accessible to more families.
   1. By increasing the income eligibility threshold for KidsCare to reflect the increased cost of living, thousands of uninsured children in Arizona will have access to high quality health coverage. Learn more.
   2. Cut the wait period and keep kids enrolled year-round.
3. Allow green card holders to access health coverage. Arizona should adopt the Immigrant Children’s Health Improvement Act (ICHIA) so children and pregnant people with green cards won’t have to wait five years to enroll in AHCCCS or KidsCare.
4. Keep former foster youth enrolled until age 26. The Affordable Care Act ensured children who age out of foster care at 18 can stay covered by Medicaid, regardless of their income but that doesn’t always happen. We’ll be advancing legislation to ensure that young people who age out can stay connected to the care they need.
5. Cover oral health care through Medicaid. AHCCCS is one of the largest sources of health coverage in Arizona, but does not provide routine, preventive oral health care services to adults. As a result, too many Arizonans are forced to wait until a situation becomes dire to seek care in the emergency room for preventable oral health concerns. We can change that by adopting comprehensive oral health coverage for adults enrolled in AHCCCS.

When someone enrolled in AHCCCS gives birth, their coverage may expire just sixty days after their pregnancy ends.* Sixty days is not much time to recover from childbirth. And it means many people are forced to forego necessary postpartum health care due to the expense. For people with physical or mental health complications after pregnancy, having reliable health coverage can mean the difference between life and death. In fact, a report requested by the Arizona state legislature found that having health insurance reduces the likelihood of death during or in the year after pregnancy.

Changes in federal Medicaid policy mean it’s now easier than ever for states to expand postpartum coverage to a full year after pregnancy.** CAA and our partners are working now to ensure our state policymakers act on this opportunity.

CAA has launched a “Post-partum Post Card” campaign to help raise awareness of the need for postpartum AHCCCS coverage. We want to make it quick and easy for you to take action.

We’re collecting messages to share with our lawmakers. Our goal is to collect as many messages as possible. We’ll print the message on a postcard, then deliver a joyful advocacy bundle when the 2022 legislative session begins.

If you’d like to participate, here are three easy steps:

1. Peruse our brief fact sheet to learn more about this issue
2. Pick a postcard – images are available at this link.
3. Fill out your home address and home zip code on the form linked above (we will never sell or share your information, we just want to make sure your postcard makes it to your representatives.)
4. Write a short note to your state lawmakers. Tip: share why postpartum coverage is important to you and/or what it would mean to your community.
5. Spread the word far and wide: Medicaid coverage saves lives.

Visit the postpartum postcard message collection form to choose a message and add your comment. Please submit comments no later than December 10th, 2021.

Thank you for your advocacy!

*Racial and ethnic disparities in pregnancy-related morbidity and mortality persist, and are driven by systemic inequities in access to care and culturally-responsive treatment. CAA wishes to note that for individuals who do not qualify for full Medicaid coverage due to their immigration or citizenship status, only delivery is covered. For these individuals, access to affordable, comprehensive pregnancy care begins and ends with delivery. CAA is committed to finding policy solutions that will promote access to prenatal and postpartum care for all Arizonans, regardless of immigration status.

**The Build Back Better package passed by the U.S. House of Representatives would mandate a year of postpartum Medicaid care. If enacted by the Senate with this provision, Arizona’s legislature will need to grant AHCCCS statutory authority to enact this change.

If state budgets are an indication of our government’s values, this year’s state budget is a terrifying reflection. In the midst of a pandemic that has ravaged communities and left more than 113,000 American children without a parent or custodial grandparent, the legislature did not make any significant investments in health care.

Instead, lawmakers tried to strip away the ability of schools and local governments to mitigate the spread of COVID-19. Through an unprecedented - and unconstitutional - budget process, lawmakers prohibited public schools from requiring masks or COVID-19 vaccines. This provision does not apply to private schools. This will inevitably exacerbate the disproportionate impact of the pandemic on Arizonans who have low incomes and are Black, Indigenous, and people of color.

Moreover, the legislature used the budget to prevent cities and towns from creating COVID-19 vaccine “passports,” from requiring businesses to secure proof of vaccination, or issuing mask mandates. It also prohibits other mitigation measures, like lockdowns or curfews.

We’ve lost too many Arizonans to this horrific pandemic, and too many kids have lost families. Our state budget disregards both science and the sanctity of human life. That is why last Thursday Children’s Action Alliance joined education advocates, parents, and physicians in taking the state of Arizona to court.

We’ve got a lot of work to do and we need your help. Please donate to support this legal challenge.

THE BACKGROUND:

Arizona’s budgeting process has never been fully transparent. The package of bills that comprise the budget is assembled behind closed doors and voted on, often in the middle of the night, with limited public input.

This year’s process was even murkier than usual. In a 171-day marathon session, the state legislature passed its budget at around 5 pm on June 30th - narrowly evading the government shutdown that would have occurred at midnight on July 1. The budget passed on party lines, with Republicans holding a single vote majority in both the State House and State Senate.

The state budget consists of several bills that outline how the state will spend money in the coming fiscal year. The “feed” bill establishes the spending, while issue-specific budget reconciliation bills (“BRBs”) provide context and statutory changes needed to expend the funds as directed.

Under the Arizona State Constitution, bills passed by the state legislature must pass the “single subject” test, meaning the bill must pertain to a defined topic. The content of the bill must also be reflected in its title.

But this year’s budget bills do not meet these requirements. Instead of simply outlining the budget processes, the legislature slipped in significant policy changes unrelated to the BRBs in which they are located. Many of these changes had been separate bills that did not have support on their own.

This doesn’t just defy the state constitution’s single-subject rule – it sets a terrible precedent for future state budgets, and it strips the public from participating in our democratic process.

Arizona has long had some of the most linient childhood vaccination policies in the nation. Parents of children enrolled in school or child care can refuse to immunize their children by submitting a medical, religious, or personal belief exemption. The use of these exemptions has skyrocketed over the past few years. Unsurprisingly, our schools are rapidly losing herd immunity to diseases that pose a serious risk to children, older adults, immune-compromised individuals, and pregnant people and their newborns.

In the 2020-2021 school year, kindergarteners in Arizona fell far short of recommended benchmarks for protecting the community from measles, mumps, and rubella. Only Yuma and Santa Cruz counties exceeded the 95% threshold needed to achieve community immunity from these diseases.

The newly approved budget passed by Governor Ducey and the Legislature further compromises our ability to protect those with vulnerable immune systems. Tucked in the budget is a blanket prohibition on “COVID-19 vaccine passports.” It also prohibits schools from requiring the COVID-19 or HPV vaccines, and adds layers of red tape that must be completed by the Arizona Department of Health Services before any new vaccine can be required for school attendance.

A new report by researchers at Georgetown’s Center for Children and Families sheds light on a growing crisis, one fueled by inequity in our health care systems.

During 2020, visits to pediatric offices declined by a cumulative 27%, meaning fewer children were receiving timely developmental screenings, scheduled vaccines, and other routine and preventive care. The impact of this decline in pediatric visits is starkly apparent in data from the Centers for Disease Control and Prevention (CDC) and Vaccines for Children (VFC) programs: in 2020, the number of childhood vaccine doses ordered by physicians decreased by 11.7 million.

This fact is compounded by the disproportionate impact of the COVID-19 pandemic on certain populations, including Black and Latinx communities* and low-income households, who are more likely to have missed a routine pediatric visit during the pandemic and who were less likely to be on track with recommended vaccination schedule prior to the health crisis.

The state’s approach to public health policy leaves us all exceptionally vulnerable – not just to COVID-19, but to future pandemics that will be attributable to this reduction in childhood vaccination rates. We hope common sense leadership and evidence-driven policy will be willing to speak up for science and dismantle the harm caused by anti-vaccine sentiment in coming years.

*Data was suppressed for American Indian / Alaska Native children. CAA acknowledges this omission and respects Tribal data sovereignty.

Have you heard the news? This morning the Supreme Court of the United States determined that the Affordable Care Act (ACA) is here to stay. The 7-2 ruling by the court is a huge victory for all Americans, including the 31 million people who currently have health insurance through either the ACA Marketplace or Medicaid Expansion. If the Court ruled the other way, these individuals would have been in immediate danger of losing their health care during a deadly pandemic.

Legal challengers to the landmark health care law – including Arizona’s Attorney General Mark Brnovich – argued that because the Tax Cuts and Jobs Act of 2017 set the tax penalty for not having health insurance at $0, the entirety of the ACA was unconstitutional. The Supreme Court largely saw through this argument, with only Justices Alito and Gorsuch dissenting.

It’s unfortunate that this meritless case made it to the highest court in the U.S., and we hope that this ruling will be enough to end the frivolous attacks on this pivotal law.

In Arizona, nearly 74,000 kids currently have access to high quality health insurance thanks to the ACA’s Medicaid Expansion provision. Another 54,000 Arizona children are currently insured by KidsCare – restoration of which was made possible by the ACA. An additional 177,228 Arizona adults and children have thus far found low- or no-cost coverage through the ACA Marketplace during the 2021 Open and Special enrollment periods.

The ACA Marketplace Special Enrollment Period will last until August 15th. If you or someone you know need help finding your best health care option, make an appointment with a health care enrollment specialist by visiting coveraz.org/connector, calling 1-800-377-3536, or 2-1-1.

The American Rescue Plan Act (ARPA) was signed into law by President Biden on March 11th, 2021. The Act provided immediate economic relief to individuals, families, localities, states, and Tribal nations. It made significant investments in communities by providing funding for broadband infrastructure, rental and mortgage assistance, and relief for small businesses. And, importantly, it took steps to make health insurance coverage more affordable for more American families. Now we need Congress to make these changes permanent.

The Act makes more people eligible for premium tax credits, which help cover some or all of the cost of health insurance on the Affordable Care Act Marketplace (Healthcare.gov). These credits are capped at the percent of modified adjusted gross income. Under the ARPA, individuals and families earning less than 150% of the Federal Poverty Level (just under $40,000 per year for a family of four) will pay $0 for health insurance purchased through healthcare.gov. In Arizona, 302,000 people are expected to qualify for health care at no monthly cost, including 207,000 uninsured adults. Another 253,000 uninsured adults are likely to qualify for low-cost health coverage under these guidelines.

Arizona Senators Kelly and Sinema have signed on to a letter urging President Biden to prioritize health care affordability. Please take a moment to thank them for their advocacy.

Send a thank you to our Senators

Enhanced premium subsidies aren’t the only important health provision of the ARPA:

• The Act provides financial incentives to expand Medicaid in states that have not yet done so.
• It makes it easier for states to expand Medicaid coverage to birthing people for up to 12 months after delivery. Arizona’s program provides coverage for just six weeks postpartum, a fact that is readily apparent in our state’s high maternal mortality and morbidity rates, especially among American Indian persons.
• It clarifies that the federal government will pay for 100% of Medicaid costs for COVID-19 testing, vaccination, and treatment-related expenses.
• It guarantees that the federal government will pay for 100% of the cost of care delivered to Medicaid participants at Urban Indian Health Centers for two years.

Unfortunately, many of these provisions – including the healthcare.gov premium tax credits – have only been temporarily authorized, and other barriers to coverage persist. Take, for example, the “family glitch” - a faulty definition that determines eligibility for Marketplace subsidies on the cost of employer-sponsored health premiums for an individual but not their dependents. This prevents 124,000 Arizonans from accessing affordable health care. Though President Biden has requested an examination of the family glitch and ARPA expanded subsidy eligibility to higher-income earners, this issue will continue to prevent many people from accessing care until it is fully addressed.

Stay tuned for advocacy opportunities to repair the family glitch and make permanent the ARPA health insurance affordability provisions.