MHA logo
Website        About MHAAZ       Contact Us
In This Issue


Like us on Facebook

November 15, 2014

It's Time: Time to Get - and Keep - Health Insurance.  It's the Affordable, Healthy Choice  
It's time for open enrollment, from November 15 to February 15. People who got covered through the Health Insurance Marketplace need to renew their coverage. People who didn't now have a great opportunity to get affordable coverage that meets their needs.

It sounds overly simple, but health insurance largely works the same way as car insurance. When you're driving around town - no matter how carefully - you're at risk of an accident no matter how safely you drive. If it happens, you're thankful that you purchased coverage. And you know that having car insurance is the law. You need it to avoid a serious penalty.

With health insurance, you can do everything in your power to stay healthy, but things happen - like a broken bone or sudden illness - that can change things in the blink of an eye.

The good news is that the Health Insurance Marketplace makes insurance affordable. In Arizona, there are hundreds of low-cost plans available. Last year, 8 out of 10 people received financial help that lowered their costs. In fact, the average monthly premium paid was $94.

On the other hand, there are penalties if you are not covered - just like with car insurance. In this case, you'll pay either $325 or 2 percent of your household income - whichever is higher - if you don't get covered by February 15.

If you got health insurance coverage through the marketplace last year, you need to follow five easy steps. Go back to the marketplace website, to (1) review available plans (including the one you signed up for last year, which may have changes), (2) update your personal information (including any changes to income), (3) compare your plan to any new options, and then (4) choose and (5) enroll. Arizona has three new plan providers this year. In some cases rates went up, but in others they went down. So shop around!  

If any of that sounds like something you don't want to do yourself, then there is more good news. Arizona has hundreds of free, licensed assisters statewide who can help. Finding and making an appointment is as simple as going to  and entering your Zip Code. Take advantage of one-on-one personal help from people who are certified and experienced. You'll be glad you did.

Just like most people are happy to have insurance when their car is involved in an accident, last year 3 out of every 4 people who enrolled through the Marketplace were satisfied with their experiences, and 9 out of 10 were satisfied with their doctors and coverage.

Bottom line: health coverage is affordable. It gives you peace of mind against unexpected health issues and their cost. The time is now, especially since you'll pay a fine if you don't act by February 15. And licensed assisters are ready with free one-on-one help to get the coverage you need.  

Don't miss this chance to help yourself and your family. Steer on over to this site to find a location near you and to set up an appointment for free, in-person help. 

By Jon Ford, St. Luke's Health Initiative  
Restoration and Expansion Challenged in Arizona's Supreme Court

In the spring of 2013 many of us celebrated the passage of legislation that allowed AHCCCS to restore the childless adult program and adopt the expansion of AHCCCS up to 133% of poverty.  The vote in the Senate was 18-11-1, the House vote was 33-27, and the Governor willingly signed the bill as a way to move Arizona forward.  Since the bill became effective in January 2014, we have seen 203,370 childless adults added back to the program and 31,019 people receive coverage under the expanded program.  We advocates had a true reason to celebrate in 2013.

Funding for the restoration and expansion effort was from a hospital assessment which garnered $75 million for FY 2014 and will garner $233 million this current fiscal year.

A lawsuit challenging the restoration and expansion was brought against the Governor by 36 Republican legislators who did not vote for the bill in 2013.  These legislators assert that the hospital assessment is a tax which requires a 2/3s vote (a 40-20 vote in the House and a 20-10 vote in the Senate).  The requirement to impose a higher vote requirement for a tax increase goes back to a voter approved initiative from 1992 known as Prop 108.

Last February, the legislators lost in Superior Court on the question of their standing to bring the lawsuit.  The legislators appealed that decision which was reversed by the Court of Appeals in April.  The Governor appealed that decision to the State's Supreme Court with a hearing on November 6th.  

The first question to be resolved is whether legislators who fail to "win" the day can appeal to a court to reverse a decision made by the legislature.  The appeals court decision said lawmakers may sue over their contention that a hospital assessment funding the expansion is a tax requiring a two-thirds vote of the Legislature. The Governor's lawyers say the assessment isn't a tax and the high court should not let the losing lawmakers sue.

According to press coverage of the hearing, there were tough questions for the Governor's lawyers as they tried to persuade the justices to overturn a decision allowing a challenge to the Governor's Medicaid expansion plan to proceed.  Questions focused on whether throwing out the lawsuit would "eviscerate" a state constitutional requirement that tax increases require a two-thirds vote of the Legislature.

The Governor's attorneys pointed out there were political remedies that could be tried, including repealing the bill in the next session or referring it to the voters. There was a prior effort to refer the question to the voters, but proponents could not get enough signatures. We are hoping that the justices will issue a ruling on whether the lawsuit can proceed before the end of the calendar year.  

We celebrate the restoration and expansion, but we need to be ever vigilant about court and legislative actions.   

A Tale of Two Courts, Version 2.0

As we reported in August, this last summer two federal Appeals Courts in different jurisdictions came to different conclusions about the legality of individuals continuing to receive Premium Tax Credits to underwrite a portion of their insurance premiums.  The subsidy amount varies by family size and household income (up to 400% of federal poverty).
At the heart of the challenge is whether the Premium Tax Credit is available to residents in Federally Facilitated Marketplace states (FFM states).  Arizona, along with 34 other states, has their Marketplace Exchange managed by the federal government.  Estimates are that 5.4 million people are enrolled in the federal marketplaces, with over 75 percent using the Premium Tax Credit to lower their monthly premium amount.  Without the tax credits, many would struggle to make monthly payments for premiums.  So what happens in King v. Burwell before the US Supreme Court does matter, a lot to all of us and the individuals and families who use the credit to pay for their health insurance premium.

According to an analysis by St. Luke's Health Initiative, over 120,000 Arizonans now have health insurance coverage in the Federally Facilitated Marketplace, and 77 percent are using the premium tax credit to help make their monthly premiums affordable.

We must remember that:  1) Open enrollment starts November 15th and is not affected by the decision of the U.S. Supreme Court decision to hear this case; and, 2) There is no immediate impact on the use of premium tax credits to lower the cost of health insurance plans purchased through the Marketplace.

Are we out of the woods yet for the ACA, or as the popular media calls it, Obamacare?  Not yet, we expect to see other court challenges, and possibly another round of efforts under a Republican controlled Congress next year to repeal, amend, or defund the Act.  Watchful we must be!! 
 Upcoming Events

Have you seen the Xmas tree decorations and lights in the stores yet?  The season is upon us.  Are you ready?  Neither am I.  Let's see if there's a coming event that will help you procrastinate a little longer.   

Please share your events with us so we can let folks know what's going on.  

1. Enroll in the ACA's Marketplace.  Open enrollment starts on Thursday, November 15th and runs through February 15th, 2015.  This is indeed a shorter window, so let's get you or your family enrolled.  Go to  to find a navigator or assister who can help you enroll.

2. Celebrate Thanksgiving on Thursday, November 27th.  

3. The Phoenix Area Out of the Darkness Community Walk, sponsored by AFSP Arizona Chapter, is Saturday, December 6th at Kiwanis Park, W. Baseline Road at S. Ash Ave. in Tempe.  The Walk starts at 10:30 am.  Contact or go to this site to register.

4. Applied Suicide Intervention Skills Training (ASIST), a 2-day interactive suicide first aid workshop will be offered on December 8 and December 9 from 8:30 am to 4:30 pm at Halle Heart Museum, 2929 S. 48th St., Tempe.  Provider agencies register here, and community members can register here .

5. Festival of Trees is an upscale evening of fun and entertainment with holiday décor by top Valley designers at the 7th Annual Festival of Trees.  This will be hosted on Friday, December 12th from 6-9 pm at the Arizona Center, 400 E. Van Buren.  Buy tickets here .  The evening will benefit PSA Art Awakenings, which supports youth and adults with behavioral health illnesses. 
Thanks Again
Again we want to acknowledge the support of Johnson & Johnson
Health Care Systems, Inc.

We invite your participation and sharing of this newsletter by forwarding to your friends and colleagues.  If they wish to receive the free newsletter, encourage them to simply click on the link here.  Let's share the word.  Let's get involved.
Eddie L. Sissons
Executive Consultant
Mental Health America of Arizona | | |

Copyright © 2014. All Rights Reserved.