Southern AZ officials: Health insurance cuts will have ‘ripple effect’

NOGALES — Healthcare providers are expecting a decrease in insurance coverage over the next few years. In response, the Mariposa Community Health Center is planning education efforts to ensure local residents continue to have affordable access to medical care.

CEO Amy Taylor, alongside Chief Medical Officer Eladio Pereira, briefed the County Board of Supervisors on Oct. 1 about upcoming changes for Medicaid, Medicare and Marketplace insurance plans.

"We are just studying the changes that are coming out of the One Big, Beautiful Bill (OBBB) because they impact us just like they impact everybody," Taylor said.

"I think the concern that we all have is the loss of Medicaid enrollees, and we expect that there will be a significant loss by later this year," Pereira added.

The OBBB did not include an extension for advanced premium tax credits for insurance plans purchased through the Marketplace, Taylor said – meaning those subsidies that make coverage more affordable will expire at the end of December.

What's more, she noted, the Marketplace will consist of shorter enrollment periods, tripled costs, and a 90% reduction in eligibility for health coverage. For instance, she said the federal government seeks to bar non-U.S. citizens from accessing public benefits, including health insurance. Attorney General Kris Mayes, however, filed a lawsuit against the latter, allowing healthcare providers to continue treating anybody regardless of immigration status while the matter is resolved in court, Taylor said.

Taylor and Pereira also noted that there are about 1.9 million people currently covered by the Arizona Health Care Cost Containment System (AHCCCS), the state's Medicaid program that provides health insurance for families with limited income. Over the next three years, they expect to see up to 450,000 Arizonans lose their AHCCCS and Medicare coverage due to cuts included in the OBBB.

And at the state level, an additional change kicked in on Oct. 1: The Arizona Division of Developmental Disabilities will provide less funding for families with children with disabilities, Pereira said. That includes less financial assistance for full-time caregivers and necessary therapies.

"The difficult thing about this is parents will have to make choices (of) caring for their children without pay and not being able to work," Taylor said. "And this is probably our most vulnerable population."

Minimizing the impact

The lack of affordable healthcare will have multifaceted impacts across communities, Pereira said.

"People delay care when they don't have insurance. They're afraid of the cost of care," Pereira said.

When patients don't have access of affordable primary care, they tend to opt for emergency rooms instead. But delaying preventative care often puts a strain on limited emergency resources at a much higher cost, he added.

"We expect emergency departments to see a significant increase in number of patients who've lost insurance and cannot find or afford primary care, preventative care or even specialty care," he said.

Taylor drew a comparison to the Covid-19 pandemic: More people visited emergency rooms, the hospitals became overcrowded, and doctors were ultimately pushed to delay routine procedures.

"And if hospitals do not have the Medicaid reimbursement, Medicare reimbursement, the problem is that they're going to have to cut their services, and then that impacts everybody who does have insurance," she said.

"There's a ripple effect. It doesn't just impact people who lose coverage. It impacts all of us in the community and that's why it's so important that all of us are really well educated on these issues," she added.

In an attempt to soften the impacts in Santa Cruz County, Taylor said MCHC will still count with its sliding fee discount program, which provides free care for families of an eligible size and income. She added that MCHC also offers payment plans, discount programs and is working with the state's Undue Medical Debt program, which wipes away people's medical debt if eligible.

Additionally, she said MCHC will work to educate and assist patients to help them maintain their Medicaid, Medicare or Marketplace insurance coverages. With Medicaid, for instance, enrollees will now be required to show proof of 80 hours of community engagement each month, which could include work, school or volunteerism, Taylor said.

"So we're thinking, how can we work with our workforce development because that can help Medicaid recipients demonstrate… that work requirement," she said.

Taylor noted that while the biggest healthcare cuts from the OBBB won't take full effect until 2027, now is the time to be proactive in educating the community about ways to be prepared.

"No one will be turned away for care – whether they have insurance or don't have insurance, whether they have the ability to pay or not," she said, encouraging the public to reach out to MCHC for assistance.

The Mariposa Community Health Center currently has six clinics: three in Nogales, one in Rio Rico, one in Tubac and another in Patagonia. For more information, visit mariposachc.net.