State market would improve access to health care | Arizona Capitol Times

Gov. Katie Hobbs demonstrated her political acumen during her recent showdown with the Republican-controlled legislature to pass an $18 billion bipartisan budget. She worked diligently with both sides to negotiate a deal that addressed some of the state’s greatest needs, especially affordable housing, infrastructure, and expanding health insurance for children. While these articles will have a positive impact, the state could take an even more consequential and bipartisan public health step by creating its own statewide exchange and moving away from the federal marketplace created by the Affordable Care Act.

The move from the federal healthcare purse to a state model will aid Governor Hobbs’ efforts to reduce costs and improve the health and well-being of all Arizonans. It would free Arizona to make the best decisions for its residents, while providing better cost efficiency, greater transparency, and more flexibility and autonomy in determining how best to reach targeted populations. And it could be crucial in providing access to health insurance for women in Arizona, a key priority of the Hobbs administration.

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Erica Korbulic

Each state operates a health care exchange through which Americans without access to insurance can purchase an affordable plan. In some states the federal government operates a federally subsidized market, while others have a hybrid state-federal model. An increasing number of states have their own markets, which they keep independent of the federal government.

Financially, state-based exchange states can keep operating costs low, leading to lower monthly premium costs for consumers who today find insurance too unaffordable. Insurers participating in the federal or state market must pay an assessment or utility fee, which is typically passed on in the form of higher premiums to health care consumers. However, states that create and operate their own markets can lower that fee and save residents money.

For example, the Idaho State Exchange has saved residents nearly $41 million in assessment fees and officials based on previous successful outreach efforts to quickly raise awareness about bigger tax credits and other benefits. Through earned media efforts and a paid advertising campaign, they increased enrollment and ensured that residents knew where they could get affordable health coverage. Pennsylvania was able to expand health coverage through its outreach efforts, seeing an increase of nearly 3,000 enrollments in its Hispanic/Latino population from 2021 to 2022. In Nevada, through the ability to respond quickly to changing policies and circumstances During the Covid pandemic, the state saw a 21.5 percent increase in enrollment from 2019 to 2022, according to the Kaiser Family Foundation.

Even the move to a state exchange couldn’t come at a more pivotal time for Arizona women, especially. Governor Hobbs has prioritized women’s health care as an initial priority for his administration Currently, more than a quarter of a million women in the state have no health insurance.

Nationwide, an alarming 10 million women, or 11 percent of women ages 19 to 64, have no health insurance. According to the Kaiser Family Foundation, Arizona’s rate is even higher at 13%. Additionally, 38% of women have skipped preventive care and 23% have skipped medical care during the pandemic. In the United States, women are dying of preventable reasons at the highest rate in the world, skipping crucial preventive services like mammograms or Pap smears. Two deaths in 1,000 among women could be prevented, and access to insurance could be key.

Yes, Arizona’s new budget agreement includes provisions to ensure better access to health care for all Arizonans. But the state should seize this moment and build a bridge to an even better future for the state by shifting to a state-based trading model. This move would put the state in the best position to expand coverage, save money, and give Arizona an opportunity to do what’s best for Arizona.

Heather Korbulic is vice president of policy and communications at GetInsured, where she engages local, state and federal health policy leaders in developing strategies for technology-led improvements to health care delivery and other public benefits.



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