The Grand Canyon State is known for many things. It was the last contiguous state to enter the union, in 1912, although it was acquired as a territory following the Mexican-American War, and subsequently the Gadsden Purchase.
In addition, its unique climate makes it a popular destination for travelers, especially during the winter months, when cold weather plagues northern neighbors. With desert land in the south and mountainous, forested areas in the north, residents and vacationers alike can enjoy mild temperatures and ski runs in the same day.
Of course, even the most beautiful landscape pales in comparison to the Grand Canyon in the northern part of the state. In other words, there’s a lot to love about the great state of Arizona, which lends itself to outdoor living and nature enthusiasts.
With all the fresh air and scenery to enjoy, you might think Arizona residents are among the healthiest in the U.S. However, healthcare is an essential part of our country’s infrastructure, and must be provided for all citizens under the law.
With the passage of the Patient Protection and Affordable Care Act (ACA, or as it’s more commonly known, Obamacare), every citizen was made responsible for carrying qualifying health insurance and every state was tasked with providing affordable insurance options.
How has Arizona fared? How does it stack up against other states, and what changes has Obamacare elicited in this southwestern region? Here are a few things residents should know about health insurance in Arizona.
U.S. health rankings include all fifty states and the District of Columbia. In 2009, Arizona ranked 40th on the Scorecard on State Health System Performance due to issues like high rates of uninsured children, obesity among adolescent and teen demographics, and adults over 50 failing to receive recommended screenings and preventive care.
However, Arizona has since taken strides to improve their health rankings, climbing four spots to rank 36th in 2014. In the same year the state earned a ranking of 29th on America’s Health Rankings, which considers different criteria, including alcoholism and STDs, among other factors.
Although Arizona politicians were initially largely opposed to Obamacare (both senators and four of eight representatives voted against it, while the governor opposed the ACA), and even residents voted to approve a measure that would bar rules forcing residents to obtain health insurance, the state has since gotten with the program, so to speak.
Effects of Obamacare
The ACA was created and enacted with the purpose of bringing affordable healthcare options to millions of uninsured Americans. The law was intended to abolish discriminatory practices (like charging women more for insurance because they “might” get pregnant), eliminate special circumstances for pre-existing conditions, and help low-income individuals and families (as well as other underserved groups) gain access to preventive and emergency healthcare.
The Obamacare individual mandate took effect in 2013 and a poll in 2015 showed that Arizona’s rate of uninsured residents had dropped nearly 6% in that time, to a rate of 14.3% of residents without insurance. This still leaves Arizona on the high end for the uninsured, as compared to a national rate of 11.7% as of 2015.
In 2014, over 120,000 Arizona residents signed up for qualified health plans, while more than 205,000 selected such plans the following year (although only 48% of enrollees were new to the state exchange). As in many states, acceptance of and compliance with the ACA continues to grow as the kinks in the system are slowly worked out, providing more Americans than ever before access to affordable insurance options and essential healthcare services.
Since the implementation of Obamacare, Arizona has opposed the law, refusing to set up its own state health insurance exchange along with many other states, instead allowing the federal government to provide and manage the state exchange. To date, several insurance providers have dropped out and no longer offer health insurance through the exchange.
Meritus announced plans to back out in October of 2015. Time Insurance Company also announced plans to withdraw earlier in 2015, as part of parent company Assurant’s decision to withdraw from state exchanges nationwide. The University of Arizona Health Plans also announced intentions to withdraw from the exchange.
The Arizona exchange still features eight different insurance carriers as of the 2015/2016 open enrollment period, including Aetna, Blue Cross Blue Shield of Arizona, Cigna, Health Choice, Health Net Life Insurance and Health Net of Arizona, Humana, Phoenix Health Plans, and United Healthcare. However, the first three now offer only HMO plans through the state exchange, having removed their PPO offerings.
Rates for plans offered through the insurance exchange are also on the rise and plan options are changing (in some cases due to carriers dropping out or offering only certain types of health insurance policies). Many Arizona residents enrolling or re-enrolling in Obamacare in 2016 were impacted by these changes.
In April of 2015 the state passed a law (HB2643) that essentially bans the creation of a state-run exchange by the state of Arizona. This law should have little impact since the federal government is already managing the state exchange.
Although state leaders in Arizona have been loudly opposed to the ACA in many cases, one area that has received support is Medicaid expansion. Many states reluctant to set up state health insurance exchanges also refused to expand Medicaid coverage beyond federal provisions. Former Arizona governor Jan Brewer pushed hard for this particular reform.
Despite contestation, a bill authorizing Medicaid expansion in Arizona was enacted in 2013 and currently remains in effect. Opponents of the bill claim that funding for the program is a tax measure and therefor requires a supermajority vote to pass.
The state, on the other hand, has dubbed the funding method as an assessment, requiring only a simple majority. The Arizona Supreme Court ruled in 2014 that a lawsuit over this issue could proceed, but the Medicaid expansion remains in effect in the interim.
As of 2015, 1.18 million Arizona residents were enrolled in the Medicare program, which is almost 17% of the state’s population. Of that number, 83% qualify due to age, while the rest are granted Medicare assistance due to disability.
Although the number of uninsured residents in Arizona remains higher than the national average, many needy citizens have been able to take advantage of affordable health insurance options, as well as state assistance thanks to Medicaid expansion.