New Arizona law provides clarity regarding firefighters’ health insurance

PHOENIX — State lawmakers have decided that firefighters in Arizona should not have to go through the hassles that Matthew O'Reilly had with his insurance company.

It's all because of a comma — or, more to the point, a missing one, in state law.

What they learned is that how text is formatting can make all the difference in the world.

O'Reilly, a firefighter in Sun City, was diagnosed with a type of cancer after a routine screening. He had his thyroid removed and went through recovery.

But even as he was healing, O'Reilly said the insurance company that was providing workers' compensation coverage insisted that the type of cancer he had just wasn't covered.

Why?

It turns out that the list of diseases that state law says are presumed to be job-related for firefighters was worded to cover "adenocarcinoma or mesothelioma of the respiratory tract," leading the insurer to conclude his non-respiratory adenocarcinoma was not covered.

Put simply, according to Sen. Kevin Payne, there should have been a comma after adenocarcinoma that would have made it clear the provision about respiratory tract was meant to include only mesothelioma.

O'Reilly said the cancer diagnosis made him focus on things like family and treatment and recovery.

"I never thought about having to fight for my benefits, whether you should about whether an insurance company's going to fight for a comma," he said. "But here we are."

That resulted in having to fight for more than a year.

"During that time I was trying to heal, I was also dealing with hearings and legal arguments, uncertainty of whether my benefits were going to be covered or not," O'Reilly said.

"As firefighters, we know that the job comes with risks," he said.

"But if one of those risks gets you sick because of the job, we should not be abandoned, we should not have to prove over and over against the law of what the law means and what it's intended to mean."

O'Reilly eventually did get his coverage. But what's in Senate Bill 1215 should make that unnecessary for others who find themselves in the same position.

Burned by the issue of punctuation, Payne, a Peoria Republican, recrafted the law so the list of presumptively covered conditions is no longer in a single sentence. Now, each of the 23 conditions has its own numbered paragraph.

"SB 1215 matters because it helps ensure the next firefighter does not have to go through what I went through," O'Reilly said.

"It means firefighters diagnosed with a covered job-related cancer can focus on treatment, recovery, and family instead of fighting insurance companies," he said at a ceremonial signing of the bill by Gov. Katie Hobbs.

"This is not just about punctuation," said O'Reilly. "It's about people."

Dan Freiberg, president of the 9,000-member Professional Fire Fighters of Arizona, said the legislation sends an important message.

"Arizona will not allow insurance companies to exploit ambiguity in the law at the expense of sick firefighters," he said.

Firefighters also gained another change in law designed to protect their health and prevent them from becoming ill in the first place.

House Bill 2641 also was signed prohibits the use of PFAS — a category known as "forever chemicals" — in the foam used by firefighters to put out blazes.

The chemicals help the foam spread over burning flammable liquids, helping to shut off the flow of oxygen.

Arizona lawmakers, aware of the health hazards, had previously forbidden the use of PFAS, which have a known link to cancer, in foam used for testing and training. But it left the door open for other uses when actually fighting fires.

Rep. Sarah Ligouri said there is no reason for that exception given the known health hazards from the chemicals.

"Firefighters spend their career running toward danger," said the Phoenix Democrat.

"Every time a firefighter answers a call they accept risks the rest of us hope we never have to face," she said. "But they shouldn't have to prevent risks that are preventable."

Liguori, noting the inherent risks of cancer to firefighters, said it makes sense to eliminate at least one risk factor.

She also said anything that reduces the use of PFAS helps everyone else, what with the chemicals showing up in drinking water in many communities.

The immediate ban on PFAS in firefighting foam in Arizona does have an exception for public airports — at least through the end of 2030. That is in line with changes to the Federal Aviation Administration Reauthorization Act of 2024 which sets the same date.

Freiberg said the theme behind both new laws is providing additional protections against the risks that come with what is inherently a "dangerous job."

"We know what it means to run toward danger when everybody else is running away from it," he said.

"But the greatest threat facing firefighters today is not the fire directly in front of us," Freiberg said. "It's what follows us home: toxic smoke, burning plastics, diesel exhaust, contaminated gear, dangerous chemicals we cannot see, we can't smell them, and we also cannot avoid them."