Arizona’s Surprise Billing Law Doesn’t Go Far Enough to Protect Patients (video)

Selah and Grandma

On Thursday, the regulatory affairs committee started bright and early with a sunset review hearing for three different departments: the Residential Utility Consumer Office (RUCO), the Department of Insurance, and the Arizona Board of Library Examiners. (This post focuses on the Auditor General’s review of the Department of Insurance.)

I have been on the Health Committee since day one and was on the Banking and Insurance Committee for two years (until it was eliminated by the Republicans). As a result, I have heard a lot of insurance bills and am very familiar with the heavy workload the Department of Insurance has. (Often, legislation gives departments more work without giving them more staff or more money.)

Primarily, my questions to the DOI director focused on surprise billing. You may remember that we passed a surprise bill in 2018. At the time, Democrats were concerned that the Republican/lobbyist crafted bill didn’t go far enough to protect patients and didn’t include a sufficient (or any) appropriation to run the surprise billing complaint department.

Surprise bills are healthcare bills that you didn’t know you owed. people generally receive surprise bills after the insurance company and the patient have paid their share of the care that was provided. The problem is that sometimes there are out of network providers, for example, in an operating room. While you’re under, you don’t know that the anesthesiologist is not covered by your insurance. We all assume that when we show our insurance card things are going to be covered.

The director said that one DOI staff person has been assigned to surprise billing, and that’s enough because not very many patients have filed formal complaints. Only 75 surprise billing complaints were received in 2019 and out of those 75 patients, 15 patients had complaints that were deemed to be legitimate for adjudication. Those 15 people got a total of $30,000.

I was shocked that the reach of this surprise billing complaint process was so minimal in a state with 7 million people. I know 15 people in my district who have surprise billing complaints, including my daughter and her husband. They have been charged tens of thousands of dollars in surprise bills since my granddaughter was discharged from the Nursery Intensive Care Unit (NICU) a year ago. Yes, more than a year after my granddaughter was born, they are still being billed. The TMC NICU holds ~30 tiny patients at a time. I am sure those other tiny babies’ families have similar surprise billing stories. And that is only one NICU in this state.

As the Democrats had theorized back in 2018, what we passed didn’t go far enough to protect patients. Rep. Kelli Butler and I worked with Senator Debbie Lesko to make her bill more patient-friendly. I insisted on a patient portal on the DOI website where people can start the complaint process and a printed notice on the surprise bill telling people they can protest the bill and giving them the DOI phone number and website address.

We need to fix this. Obviously, there are many more surprise bills out there, and people don’t understand the complete process.The DOI director said that Texas has already amended their surprise bill. He had suggestions– like lowering the threshold from $1000 to $500. He also said that they have published a surprise billing report, which he will send to me.

We should look at the report, our law and fix it. Or, we eliminate surprise billing all together and overhaul the healthcare insurance system. Medicare for all, anyone? The system we have today only works for big insurance and big Pharma, not the rest of us, obviously.

Virginia Dumped the #GOP & Passed the #ERA (video)

ERA wins multiple Capitol Times awards, 2019.

January 15, 2020 is a red letter day for the women of the United States because the Virginia Legislature ratified the Equal Rights Amendment.

While the Arizona Legislature has been tied up in pomp and circumstance, speeches, and meetings with lobbyists during this first week, Virginia got busy and passed the ERA. How did this move so quickly? The voters Virginia ousted the Republican majority from their legislature in the fall election and restored the Democratic Party to power in that state. Democrats get things done.

Now that Virginia has become the 38th and final state needed to ratify the ERA, it will be sent to the Congress to be made part of the Constitution.

Continue reading Virginia Dumped the #GOP & Passed the #ERA (video)

Microsoft Wants a Sales Tax Break Because ‘Electricity Is Too Expensive in Arizona’ (video)

starve the schools. feed the rich (sarcasm)

Should the Arizona Legislature help Microsoft pay its APS bills?

Tuesday was a light day at the Capital. There was no floor action, but I had time to catch up with colleagues and sign some of their bills. I wanted to tell you about the conversation I had with two Microsoft lobbyists about the tax break that Microsoft wants.

You may remember my blog post on Powers For The People (back in December) about the tax review committee that I was on, due to my membership on the Ways and Means Committee. One of the income tax credits that we reviewed was for an Apple international data center to be built with renewable energy in Mesa. At the time, Apple was offered a TPT (sales tax) break also, but the committee reviewed only the income tax break.

The lobbyists were in my office because Microsoft wants the TPT tax break that was offered to Apple. I told them that I really don’t support tax giveaways to multinational corporations. Period. I don’t support any tax giveaways when ~68% of Arizona women aren’t getting first trimester prenatal care, and that is contributing to AHCCCS wasting $2-4 billion dollars on premature births (Not to mention the long-term health effects of prematurity.) When thousands of Arizona mothers and their children are living in poverty with food and housing insecurity, why would I prioritize a tax break for one of the most successful corporations in the US?

The lobbyist told me that the reason Microsoft needed a TPT tax break because “electricity is too expensive in the state of Arizona.” Microsoft doesn’t want to pay sales tax on electricity for this giant data center. International data centers take a use a lot of electricity because it is a building full of servers and cooled to ~65 degrees. This particular tax break is related to data centers built with renewable (solar) energy, which will already lower their energy cost significantly.

Continue reading Microsoft Wants a Sales Tax Break Because ‘Electricity Is Too Expensive in Arizona’ (video)

Progressives & Libertarians Debate Tax Credits at #AZLeg Income Tax Credit Review (video)

Arizona Legislature tax review committee

For years, Democrats in the Legislature have been calling for a review of the tax credits and the other tax giveaways. The goal of the review process is to recommend continuation, amendment or repeal of tax credits.

Decades of “business friendly” bipartisan votes in the Legislature to reduce income taxes and boost the economy have left us with $661 million in income tax credits claimed (AKA lost revenue) and more than $1.6 billion in unclaimed tax credits, ready to be cashed in, according to David Lujan, executive director of the Center for Economic Progress.  This is not sustainable.

For the first time since 2014, the Joint Legislative Committee to Review Income Tax Credits met on Dec. 19, 2019. This was an historic day, and I was proud to be part of it.

According to statute, this committee is supposed to meet before the end of each calendar year and review tax credits that were passed in designated years. For this meeting, we reviewed tax credits that were passed in years ending in four and nine. We reviewed three tax credits that were recommended for elimination in 2014 (motion made by then Rep. J.D. Mesnard), but no action was taken by the Legislature to actually repeal them. Two of those– Healthy Forest Tax Credit and the Agriculture Pollution Control Tax Credit– were again recommended for elimination at 2019 meeting because they have been mostly unused for years. Income tax credits that are not used for more than four fiscal years are supposed to disappear, but somehow they hang around in the code, even Senator and Committee Chair J.D. Mesnard complained about this at the meeting. The majority voted to continue the other tax credits with additional performance measures attached in some cases. (For the recorded, I voted to repeal all of them. Read on and learn why.)

Continue reading Progressives & Libertarians Debate Tax Credits at #AZLeg Income Tax Credit Review (video)

Big Banks, Big Insurance, Big Pharma & Big Housing: Corporate America Is Burying Us in Fees

Thanks for the poverty

Working for a living is hard. You have to get out of bed early, get dressed… maybe even put wear a silly uniform that you were required to purchase… drop the kids off at school, drive around to find parking or sit on a bench waiting for the bus, rush to work to be on time, and repeat in reverse after work a few hours later. If you are forced to work multiple jobs to make ends meet, the complexity and aggravation of daily life grow exponentially … one grueling day after another.

Decades ago, Wall Street bankers learned that making money off of other people by charging fees for absolutely everything their accountants can think of… and then charging late fees upon those fees… is an fast route to Easy Street. Banks and other lending institutions are masters at making money from fees (as opposed to real work).

The Fee Game is now pervasive across Corporate America. As a result, We the People are getting fleeced at every turn. People complain about high taxes from the government, while Corporate America is slipping billions of dollars out of our pockets in service fees, administrative fees, application fees, late fees, nonpayment fees, stop payment fees, online payment fees, nonrefundable deposits, usurious interest rates,  junk health insurance, unaffordable health insurance premiums, co-pays, coinsurance, and the list goes on. It’s no wonder people are strapped for cash. We’re being nickel and dimed into bankruptcy by Corporate America, while Congress and state Legislatures bend over backwards to be “business friendly.” For more about The Fee Game and how lucrative it is… read on…

Continue reading Big Banks, Big Insurance, Big Pharma & Big Housing: Corporate America Is Burying Us in Fees

Maternal & Child Health! The Movie! (video)

Selah

Now that I have your attention…

Who can resist babies doing yoga coupled with multiple exclamation points?

As many of you know, maternal and child health has been my focus for nearly a year now, ever since my strong, adorable, and intelligent granddaughter Selah was born with gastroschisis. Her three months in the Nursery Intensive Care Unit (NICU) at Tucson Medical Center (TMC) in 2018 gave me a new appreciation for the human and financial costs related to adverse birth outcomes and high tech medicine.

When it comes to maternal and child health, I strongly believe that the state of Arizona can and should do better regarding:

  • Increasing access to prenatal, perinatal and postpartum care.
  • Decreasing the rates of premature and low birthweight babies.
  • Reducing the number of unintended pregnancies and nonmarital births.
  • Reducing toxic stress in and increasing opportunities for families and children by tackling chronic, systemic poverty in Arizona– particularly among single parent households.

Continue reading Maternal & Child Health! The Movie! (video)

Community Support for Striking ASARCO/Grupo Mexico Workers Grows (video)

Asarco strike

More than 1700 members from eight labor unions are on strike against ASARCO and Grupo Mexico. These workers haven’t had a raise in 10 years. Under ASARCO/Grupo Mexico’s best and final offer some workers still wouldn’t get a raise, while others will be shortchanged due to rising health insurance costs.

The Pima Area Labor Federation (PALF) is hosting Resource Fairs and Town Halls for union brothers and sisters who are on strike on October 22 at the IBEW Hall, on October 24 at Pima Community College North, and on October 25 at Good Shepard United Church of Christ (Sahaurita). Striking workers can get information, food for their families, and other assistance.

Resource Fair… will be open from 9 a.m. – 6 p.m. on October 22 and 24 but close at 4 p.m. on October 25.

Informational Meetings… will be from 11 a.m. – 1 p.m. and from 3 p.m. – 5 p.m. on October 22 and October 24. The event closes at 4 p.m. on Friday October 25.

Public Support for Strikers… People who want to support the strikers and their families can donate food, gift cards to union grocery stores (like Safeway or Fry’s), or cash through PALF. Nonparishable food donations can be dropped off the IBEW Hall, 570 N. Tucson Blvd.

Donations… You can donate checks or cash to help the strikers and their families by mailing or delivering your donation to the PALF Office at 877 S. Alvernon Way, Tucson 85711. Make checks payable to PALF Community Services.

Continue reading Community Support for Striking ASARCO/Grupo Mexico Workers Grows (video)

Maternal & Child Health… a Dialogue with Rep. Powers Hannley (video)

What is the state of maternal and child health in the state of Arizona? Well, it certainly could be better.

Arizona ranks in the 40s (out of 50 states) in many areas related to the health of Moms and their babies.

Too many Moms and babies are dying preventable deaths after childbirth. Too many babies are born prematurely, with low birth weight or with birth defects. Not surprisingly, access to first trimester prenatal care has decreased, while beginning prenatal care late or not having prenatal care has increased.

Although the Arizona Department of Health Services recently received a CDC grant to study maternal mortality, there is more work to be done to improve the lives of Moms and babies.

Arizona should be doing more to prevent premature and low brithweight babies, increase access to prenatal and post-partum care for women, and increase post secondary educational opportunities (particularly for young girls).

I will talk about the State of Maternal and Child Health in Arizona and lead a discussion about challenges and solutions at the Salt of the Earth Labor College on Saturday, September 21, 2019, beginning at 2 p.m. (Facebook event here. Blog for Arizona event here.) The College is located at 1902 E. Irene Vista, Tucson.

Continue reading Maternal & Child Health… a Dialogue with Rep. Powers Hannley (video)

Maternal & Child Health: a Public Health Model for Social Justice (video)

NICU

A few weeks ago, I gave the guest reflection at the Unitarian Universalist Church of Tucson on maternal and child health in Arizona. Below is the text of my talk or you can listen to the podcast here. I have been talking with people for months about this topic, and many of you have expressed an interest in working on solutions to improve maternal and child health. My plan is to hold stakeholder meetings on the state of Maternal and Child Health in Arizona, with the goal of crafting bills for the 2020 session. Stay tuned on the PowersForThePeople.net blog and on my Facebook page. I will be giving another talk on this topic at the Salt of the Earth Labor College on September 21, 2019.

Prevention: A Public Health Model for Social Justice (reflection text)

As the Public Health Parable in the Message for All Ages previewed, today, we are going to talk about prevention not only a public health strategy but also a social justice strategy.

Like the industrious carpenter in the video, we are going to assess the current problems, walk upstream to examine the root causes, and brainstorm long-term solutions to tackle those root causes.

Rather than focus solely on putting out fires today—as our government often does—the Public Health Parable teaches us to not only put out the current fire but also to devote significant effort to preventing those fires in the future.

My original idea for today was to discuss three unfolding public health crises: migration, housing security, and maternal and child health, but when I started to pull everything together, I realized we would be here all day if we tackled upstream solutions for those three, highly complex issues.

These three seem like disparate topics– migration, housing security, and maternal and child health—but they have commonalities.

Can you name some?  

[Pause for audience to shout out ideas.]

Poverty is a big factor in all of these, right?

But many of the “isms” are also involved: racism, sexism, classism, capitalism. And let’s not forget capitalism’s destructive cousins: war, austerity and bad policy.

How we tackle the unfolding crises of migration, housing security, and maternal and child health could have wide-ranging, positive OR negative repercussions on children, families, communities, future generations, and the climate.

Now we’re talking interconnectedness of all life, right?

Today, I want to focus on the area that has received the least amount of attention: maternal and child health. We hear a lot in the news about migration and housing, but there is a statewide and nationwide crisis in maternal and child health that is being ignored.

Continue reading Maternal & Child Health: a Public Health Model for Social Justice (video)

Why Can’t the Ronstadt Center Be an Open-Air Transit & Community Space?

Ronstadt Center, Tucson, 2013

Do you remember the controversy surrounding redevelopment of the Ronstadt Transit Center? Back in 2013-2014, developers were making a play to redevelopment the Ronstadt Transit Center. They had pitched redevelopment of the Ronstadt in the past and failed; the 2013-14 plans revolved around building something on top of the Ronstadt. I mention this ancient history because the Ronstadt redevelopment project– which I mistakenly thought had died a silent death– popped up at a recent Mayor and Council candidate forum as a good idea. Now I realize that demolition of the Ronstadt Transit Center is on the horizon– along with construction of more luxury apartments and yet another “boutique hotel.” Groan. Why are we doing this? Why are we destroying our sense of place and community on Congress Street and 4th Ave. in exchange for big boxy buildings?

The History…

Ronstadt Center, Tucson 2009
During community events like Downtown Saturday Night or the gallery art walks, dancers would perform at the Ronstadt Transit Center (2009).

Old timers like me remember the original design and intent of the Ronstadt Transit Center as not only a transit hub to bring people in and out of downtown but also a community gathering space. In fact, I often wrote about and photographed downtown when I had my writing, photography, and design business in the 1980s and later in the 2000s as a downtown artist. In addition to writing for Dateline Downtown, a weekly downtown newspaper, the Tucson Arts District Partnership was one of my clients. In the 2000s, as Wind Dancer Design, I was a member of Central Arts Gallery, one of the former on Congress Street galleries that were replaced by restaurants and bars.

The low brick walls were designed as benches and gathering spaces around the Ronstadt Center. The rustic brick, custom decorative tiles, and the large decorative brick patio area (with bricks from the Ronstadt Hardware Store, that once stood there) gave the design a sense if place and purpose. Form + function makes for good design. The patio, which had tables at one point, was designed for people to sit while they waited for the bus or had sandwich from one of the restaurants or a food cart set up on the patio.

Continue reading Why Can’t the Ronstadt Center Be an Open-Air Transit & Community Space?