The Supreme Court of the United States has set a date to hear oral arguments in California v. Texas: one week after election day, November 10, 2020. This lawsuit has the potential to overturn the Patient Protection and Affordable Care Act (ACA), which has been instrumental in providing comprehensive, quality health coverage to children across the country.

The lawsuit, known in the lower courts as Texas v. Azar and Texas v. US, was brought forth by Texas and 19 other states. They allege ACA is no longer valid because the 2017 Tax Cuts and Jobs Act set the tax penalty for not having health insurance to $0. Among those seeking to repeal the Affordable Care Act is Arizona’s Attorney General Mark Brnovich. Attorney General Brnovich and opponents of the ACA argue that a patchwork of state-level laws will protect patients in the same way. But, this is misleading.

For example, this year in Arizona, State Senator J.D. Mesnard passed legislation that purportedly provides protection against discrimination for people with pre-existing conditions. However, the law does not explicitly protect against price gouging for these individuals, and our state is woefully underprepared to enforce the law. The Arizona Department of Insurance and Financial Institutions, which investigates complaints against insurance companies, has just six investigators who oversee 1,600 insurers. Of the more than 3,000 complaints filed with the agency in FY2019, only 345 were investigated.

Children’s Action Alliance recently partnered with researchers at ASU’s College of Health Solutions to examine the impact of ACA repeal on Arizona’s children and families. The report examines key tenets of the ACA, including its protections for people with pre-existing conditions, Medicaid expansion, and its tremendous impact on reducing the rate of uninsured children in Arizona.

To read the full report, click here.

Yesterday, Governor Ducey and the Arizona Department of Health Services announced a comprehensive vaccine distribution plan to curb the spread of the flu this fall and winter. Children’s Action Alliance applauds the Governor’s effort to provide this lifesaving vaccine to everyone, regardless of immigration status or income. The COVID-19 pandemic has placed an unprecedented strain on Arizona’s hospital and health care systems. A major flu outbreak could force the health care system to fight a war on two fronts.

Influenza is one of the top ten leading causes of death in Arizona. Each year, an average of 700 people die due to the flu in our state, and young children and American Indian / Alaska Native individuals are at a particularly high risk of complications from the virus.

The Governor is taking a data-driven, multi-pronged approach to promote public health and preserve precious health care resources:

1. Significantly expanding the number of flu shots available to uninsured and under-insured people in Arizona, including undocumented immigrants;
2. Incentivizing AHCCCS and KidsCare participants to get the flu shot by offering a $10 gift card to all members who get vaccinated;
3. Increasing payments to AHCCCS and KidsCare-contracted providers who administer flu shots;
4. Allowing certified pharmacists to provide vaccines to children who participate in AHCCCS and KidsCare;
5. Expanding flu shot distribution to certain COVID-19 testing sites throughout the state, and;
6. Providing online resources for health care providers, businesses, and families to help them locate no-cost testing and take proactive steps to protect employees.

According to the Governor, the use of incentives to patients and providers and expanding availability of flu vaccines has shown a 50 percent increase in vaccine rates among Medicaid members in other states. We commend this proactive investment in community health and encourage everyone to get a flu shot as soon as you are able!

Additional flu-related resources will be available soon at azhealth.gov.

This moment makes it clear that each and every person’s health and well-being is intertwined. Yet, the policy response to the COVID-19 pandemic has explicitly left many immigrant families out. This is particularly troubling in Arizona where more than one in four children are growing up in an immigrant household. Immigrant households are heavily represented in front-line essential jobs and nearly 16 percent of small businesses are owned by a foreign-born Arizonan.

However, immigrants who paid and filed their taxes using an individual Taxpayer Identification Number (ITIN) are ineligible for federal stimulus payments and unemployment benefits. Under the federal CARES Act, stimulus payments are denied to entire families if the tax filer (or their spouse, if filing jointly) uses an ITIN, rather than a social security number.

In Arizona, 104,000 children live in an immigrant household that did not receive a stimulus payment due to an ITIN filing.

In addition to financial relief, state lawmakers can ensure everyone has access to no-cost testing, treatment, and preventive services for COIVD-19 regardless of their immigration status. Many families in Arizona have withdrawn from or have not applied for health benefits they are eligible for due to fear and uncertainty surrounding harmful policies like “public charge”. While other states have used new federal flexibilities to expand where undocumented immigrants can access emergency Medicaid (AHCCCS) for COVID-19 testing and treatment, Arizona has not. States can also allocate state funds to provide Medicaid and CHIP (KidsCare) services to all children, regardless of their immigration status.

The exclusion of certain immigrants undermines our economic recovery and public health. The next federal COVID-19 legislation should extend CARES Act financial payments to ITIN filers and Arizona should expand emergency Medicaid (AHCCCS) for immigrant families who need it.

Read the full fact sheet.

UnidosUS and the Georgetown University Center for Children and Families co-released a new report with a discouraging picture of Latino children’s health coverage in Arizona. The new report sends an urgent call to lawmakers to improve access to affordable health coverage for Latino children in our state during the pandemic. According to the CDC, over half of children (53 percent) diagnosed with COVID-19 in the US are Latino.

The report finds that more than 80,000 Latino children in Arizona are uninsured. This represents a rate of 10.4 percent, significantly higher than that of non-Latino children in Arizona at 6.3 percent. Latino children are more than 1.5 times more likely to be uninsured than their non-Latino peers and children who identify as both American Indian/Alaska Native and Latino are more than 3 times as likely to be uninsured.

Though Latino workers have a higher participation rate in the labor market, they are significantly less likely to have access to coverage through employer-sponsored health insurance. For this reason, strengthening access to coverage must be an essential component of increasing health access for Latino children and curbing the disproportionate impact of COVID-19 on Latino children.

Arizona’s leaders can take these bold steps to make sure all children can access health care:

• Arizona’s Medicaid program should allow COVID-19 treatment provided in any setting to be covered by emergency AHCCCS.
• Arizona should invest in culturally-appropriate outreach and enrollment efforts and should raise awareness of the importance of health coverage for children of all ages.
• Arizona should adopt the Immigrant Children’s Health Improvement Act (ICHIA) Option in Medicaid and CHIP, which would allow AHCCCS and KidsCare to cover many more immigrant children. Additionally, state funds should be allocated to cover ALL Arizona children, regardless of citizenship status.
• Increase KidsCare income eligibility to the national median of 250 percent of the federal poverty limit, to extend coverage to many more uninsured children who fall just above the income threshold.

Policy decisions about coverage options, especially in times of crisis, have a profound effect on children and can intensify existing racial and ethnic disparities during a crisis. We must continue to raise awareness of the disproportionate impact of COVID-19 on communities of color and to push for solutions that directly address health inequities.

In these unprecedented times, it’s more important than ever to prioritize access to quality, affordable health coverage and a robust health care safety net for every Arizonan.

Yet, the Affordable Care Act is under attack. Arizona Attorney General Mark Brnovich is among those leading the charge to repeal the hallmark health care legislation. The Supreme Court of the United States is slated to hear the case this fall. Their decision could overturn all or some crucial elements of the ACA – including Medicaid expansion, mandatory coverage for the ten essential health benefits, and protection for individuals with preexisting conditions, to name just a few.

On June 5^th, Governor Ducey signed Senate Bill 1397 into law. This bill, sponsored by state Senator J.D. Mesnard, and backed by Attorney General Brnovich, provides protection to Arizonans living with a deniable health condition in the event that the ACA is ruled unconstitutional – but the legislation does not go nearly far enough. Though the bill prohibits insurers from denying coverage, it does not contain the community rating or the essential health benefits provisions. Community rating guarantees a person won’t be charged much higher premiums because of a pre-existing condition. Without these critical protections Arizonans may be presented with a devil's bargain: pay exorbitant insurance premiums or lose access to lifesaving health care.

Without comprehensive federal legislation, the critical health benefits and rights afforded by the ACA would be severely weakened, and families in Arizona would be left with gaps in a patchwork of state-level laws governing health care.

Join over a thousand Arizonans who have signed our petition urging Attorney General Brnovich to remove himself from the California v. Texas lawsuit today, and tell all our lawmakers: #AZNeedstheACA.

In the midst of a global pandemic, undermining our nation’s health care system could mean the difference between life and death for everyday Arizonans. Over the past few months, Children’s Action Alliance has been closely monitoring action in a federal lawsuit that could overturn all or some of the Affordable Care Act (ACA). The ACA provides Americans with critical protections, rights, and options when it comes to our health care. The case, now named California v. Texas, has been escalated to the US Supreme Court. Opening briefs will be filed beginning next month and oral arguments will likely occur in the fall of this year.

Arizona Attorney General Mark Brnovich is arguing to dismantle the Affordable Care Act. Brnovich acted alone when he joined Arizona in the lawsuit that threatens the health of our economy and Arizona families. Twenty million Americans stand to lose their health coverage if Attorney General Brnovich and the other plaintiffs are successful in proving the ACA is unconstitutional. In Arizona, over 2.8 million people have a pre-existing condition. Nearly 63,000 school-aged children and over 3,100 former foster youth have health coverage today, thanks to provisions of the ACA.

We urge Attorney General Brnovich to withdraw Arizona from the California v. Texas lawsuit. We need you to lend your voice and sign our petition urging withdrawal from the suit.

Our lives are on the line. Tell Attorney General Brnovich to pull out of this harmful, reckless lawsuit today. Share this petition and your story using the hashtag #AZNeedsTheACA.

COVID-19 is a powerful reminder that regardless of where we come from or how we make a living, everyone should have what we need to be well. For many immigrant families the pandemic has exacerbated existing uncertainty and fears about seeking medical care. On March 13, U.S. Citizenship and Immigration Services (USCIS) announced that testing, prevention, or treatment for COVID-19, would NOT be used against immigrants in a public charge test or green card application. Immigrant and mixed-status families are encouraged to seek the care they need.

Click Here to Download the COVID-19 Immigrant Resources Guide in English and Spanish

Reminders for navigating public charge during COVID-19:

• Public benefits used by your family members will not count against your application. If your children or family members are citizens or already have green cards, they should continue to use the benefits for which they are eligible.
• Emergency Medicaid/AHCCCS will not count against your green card application.
• Medicaid/AHCCCS used by children under age 21 will not count against your green card application.
• Health care provided by community health centers will not count against your green card application.
• Unemployment benefits are considered an “earned benefit” and will not count against your green card application.

Great news! For the duration of the COVID-19 emergency, KidsCare health coverage premiums and any premium balances are waived! Arizona will also stop disenrollment of AHCCCS/Medicaid participants, unless the individual moves out of state or voluntarily opts out of coverage. Participants who were disenrolled during the month of March will have their coverage reinstated for the duration of the emergency.

Children’s Action Alliance commends this step and supports efforts by AHCCCS and the Governor’s office to remove financial barriers to receiving health care. This virus can only be contained if people are able to access the testing and treatment they need quickly and seamlessly. This decision truly affirms our state Medicaid agency’s commitment to stopping COVID-19. To further reduce barriers to care and help Arizona contain this crisis, CAA urges AHCCCS to expand presumptive eligibility and reinstate prior quarter coverage. These steps will reduce administrative barriers for participants and will enable people to seek health care while their applications are being processed.

A health coverage navigator can help you find low- or no-cost health insurance. To make an appointment with a navigator, visit http://coveraz.org/connector or call 1-800-377-3536. If you are not eligible for Medicaid/AHCCCS coverage, you can seek low or no-cost care at a federally qualified community health center (FQHC). To find an FQHC near you, visit https://www.aachc.org/communityhealthcenters/health-centers.