News

By Sarah Oven | Cronkite News | February 15, 2021 

WASHINGTON – Health advocates welcomed Monday’s reopening of enrollment for Affordable Care Act coverage, saying the opportunity for more people to get or renew their health insurance could be “really good for Arizona.”

The normal period for Americans to sign up for coverage ended Dec. 15, but President Joe Biden called for this special 90-day open enrollment period in response to the ongoing COVID-19 crisis.

The change could open the door to subsidized health insurance for thousands in Arizona, where as many as 900,000 people may not have health insurance, according to Dr. Dan Derksen, director of the University of Arizona Center for Rural Health. Derksen said as many as half of those people could get covered under the ACA.

“This extension of the open enrollment period Is a way that we can get more information out there so that people understand what they might be eligible for, and then get enrolled,” Derksen said Monday, the first day of open enrollment.

Matt Eyles, president and CEO of America’s Health Insurance Plans, praised the decision to reopen the enrollment period as a “timely and targeted” solution that is “exactly what Americans need.”

“Every American deserves access to affordable health coverage and high-quality care, and that is especially true during a pandemic,” Eyles said. “We appreciate the Biden administration for providing this additional opportunity for hardworking American families to enroll in coverage for their health and financial security as they continue to fight to overcome the COVID-19 crisis.”

The move also allows for further gains in enrollment under the ACA – also known as Obamacare – after years of steady declines under the Trump administration. Enrollment fell from 9.6 million nationwide in 2017 to 8.2 million in the open enrollment that ended in December. In Arizona, the numbers fell from 203,066 to 154,504 over the same period.

Advocates said the declines, which leveled off last year, were due to an “erosion” of support under President Donald Trump, including fewer staff to help people navigate the marketplace, shorter enrollment periods and a decrease in outreach resources.

The special open enrollment period, which is open until May 15, is the second move in two weeks by the Biden administration to reverse Trump administration policy in regard to the ACA.

The Supreme Court in November heard arguments in a case challenging the constitutionality of the ACA, and the Trump administration had sided in that case with opponents of the law. But the deputy solicitor general wrote the court on Wednesday to say the Biden administration “has reconsidered the government’s position” and now argues that the law is constitutional and should stand, even if the court finds part of it is flawed.

The reversals are not surprising, said Will Humble, executive director of the Arizona Public Health Association, who called the Trump administration a “little hostile” to the ACA.

“I think we have people who are making decisions to use the funds that they currently have and ways to actually try to motivate and engage people in the marketplace, which was not the case under the Trump administration,” Humble said. 

That was echoed by Derksen, who said that most people “realize that with the change in leadership at the national level there would be a renewed interest in the Affordable Care Act coverage availability.”

Health insurance in the ACA marketplace is open to anyone, but the plans are designed to provide low-cost or no-cost coverage based on patients’ income.

Advocates said many will find they can get coverage through Medicaid or the Children’s Health Insurance Program, which in Arizona go by the names Arizona Health Care Cost Containment System and Kids Care, respectively. People who exceed the income limits for those programs may still be eligible for tax rebates to make the coverage affordable.

Interested people should go to Healthcare.gov for more information about their eligibility for coverage. In Arizona, a good place to start is CoverAZ.org, where people can get free advising on their eligibility and the best plan for them, said Marcus Johnson, director of state health policy and advocacy at Vitalyst Health Foundation.

“If you don’t have health insurance right now, if you recently lost your job during the pandemic or if you’ve never had health insurance, this is a great opportunity for people to shop for quality and affordable health insurance coverage,” Johnson said.

He said it is important to realize that whatever the Supreme Court rules in the ACA case, it will have “no bearing on this current open enrollment opportunity.”

“Now is the time to jump on board and see what you qualify for if you don’t have health insurance coverage,” Johnson said Monday.

» View complete article with graphs at link/PDF below:

PHOENIX ‒ Governor Doug Ducey and the Arizona Department of Health Services today announced a partnership with the University of Arizona and the Pima County Health Department to operate a state vaccination site on the university’s mall area on central Tucson campus.

“Our state vaccination sites at State Farm Stadium and Phoenix Municipal Stadium have been instrumental in Arizona’s work to vaccinate people quickly, efficiently and safely,” said Governor Ducey. “We’re thrilled to partner with the University of Arizona and the Pima County Health Department to open a site in Southern Arizona and rapidly expand vaccine distribution. The demand for vaccine doses is high, and Arizonans have made it clear they want it. We are working hard to secure more doses from the federal government and partner with private and public organizations to get the vaccine out and protect Arizonans. My thanks to President Bobby Robbins and everyone involved for their work to partner on this vaccination site.”

The state vaccination site will expand the current capacity and hours of operation at the existing university site, which has a proven record of success in vaccinating students, faculty and staff. The transition to a state site will add more appointments that will begin on Feb. 18. Registration for these appointments will open at 9 a.m. Tuesday, Feb. 16, at podvaccine.azdhs.gov. Those without computer access or needing extra help registering can call 1-844-542-8201 for assistance. The partnership will also allow for expanded hours of operation, eventually operating 24/7 as more vaccine doses arrive in Arizona. At full capacity, the site can serve up to 6,000 people per day. 

“Serving as a COVID-19 vaccine point of distribution (POD) and delivering more than 12,000 shots to local county members from first responders, K-12 and post K-12 educators and staff over the past two weeks has been a privilege for the University of Arizona, and we welcome the opportunity to provide the same service to Southern Arizona as a 24/7 vaccination site for the state,” said University of Arizona President Dr. Bobby Robbins. “Our POD has the capacity to deliver more vaccinations, and we look forward to working together to further meet the needs of Pima County and Arizonans. I am incredibly proud of our entire team of professionals and volunteers who have partnered closely with Pima County, established the university POD, and operated it so well.”

Today’s announcement of the vaccination site at the University of Arizona comes as the university and the state are experiencing a drop in COVID-19 cases. 

“Demand for the vaccine remains high, and the state’s third vaccination site and first in Southern Arizona will help meet that demand,” said Arizona Department of Health Services Director Dr. Cara Christ. “We’ll have the ability to vaccinate more people each day at this site once we have more vaccine doses, and we are working with our federal partners to secure more supplies and rapidly expand vaccinations. We are looking forward to working with the University of Arizona and Pima County to get this site running and protect more Arizonans.”

The vaccination site at the University of Arizona will be the third state site, and the first in Pima County. On Jan. 11, Arizona opened its first state-run site at State Farm Stadium, where 178,084 vaccine doses have been administered. On Feb. 1, the state opened its vaccination site at Phoenix Municipal Stadium, where 14,946 vaccine doses have been administered. As of Tuesday, 954,290 vaccine doses have been administered across the state. 

Information about all vaccination sites across Arizona can be found at azhealth.gov/findvaccine. Note: You can use the patient portal at podvaccine.azdhs.gov to make an appointment for a relative in a prioritized group.

Arizona Republic | Stephanie Innes & Alison Steinbach | Feb 5, 2021

As the state of Arizona is quickly expanding its drive-thru COVID-19 vaccination sites in Maricopa County, some outlying counties are struggling with logistical challenges and an unreliable supply.

Nearly 150,800 vaccines have been administered at the two state-operated sites — State Farm Stadium in Glendale, which opened Jan. 11, and Phoenix Municipal Stadium, which just opened Feb. 1. That's in addition to the 344,149 vaccinations administered at Maricopa County sites. 

At the same time, officials in several outlying counties are struggling with a low and inconsistent supply of vaccine. They are having trouble planning ahead.

In Cochise County this week, officials were able to offer just 100 first-dose appointments because of a lower-than-expected allocation.

Some Cochise County residents are driving to the state-operated sites in Phoenix and Glendale, but that option "does insert some real inequities in access," said Alicia Thompson, Cochise County's health and social services director.

Last week Thompson said she felt sick to her stomach when she learned that the county's entire allocation was 1,100 doses. She immediately set aside 1,000 for pre-booked second-dose appointments, which left just 100 first-dose appointments available.

"We just don't have the vaccine and that is why I've been contacting state legislators and other people because it's just very, very erratic," said Dr. Edward Miller, chief medical officer for the Copper Queen Community Hospital in Bisbee, which is in Cochise County. "We get as high as 4,500 doses in one week and then this week we get 1,100, but 1,000 of those are designated as second doses ... So we can do 100 new vaccines this week and that's ridiculous."

Cochise County had administered 13,100 vaccines as of Friday and 1,664 people, about 1.3% of the county population, had been fully vaccinated with two doses. Statewide, about 2% of Arizona's population as of Friday had been fully immunized with the COVID-19 vaccine, state data showed.

Yavapai County also has had problems with supply and planning.

"Early on, we were told if we built this system, they (the Arizona Department of Health Services) would supply us with vaccine to hopefully push out vaccine in rural Arizona, not just in Maricopa and Pima counties," Yavapai County Community Health Services Director Leslie Horton said.

"It takes a lot of work on rural counties to pull together the resources, the staffing, the support, and we’ve done that. Now we just hope that they’ll come through on their part and provide the vaccine that we need to run these."

Governor says he has not forgotten about rural counties

State Farm Stadium in Glendale, which opened Jan. 11, administered 8,200 COVID-19 vaccine doses on Thursday and the state-run vaccine site at Phoenix Municipal Stadium increased its daily doses on Friday to 2,000, up from the 500 per day it was doing when it opened Feb. 1.

Arizona Department of Health Services officials say they'd like to ramp up to 12,000 doses per day at both sites. Both health department director Dr. Cara Christ and Arizona Gov. Doug Ducey say they have not forgotten about rural and outlying counties.

"We're focused on all of our counties. Maricopa may be getting more attention for the reason that it's the overwhelming majority population of our state. If you look at Maricopa and Pima you are talking about 85% of our state, so of course, we are going to focus our resources on that because that is where the people are," Ducey said Friday during a visit to State Farm Stadium.

State officials say supply is a problem across Arizona, and they are optimistic that the situation will improve. And erratic supply is an issue across the U.S., not just in Arizona, Ducey said.

"What we need is supply. We're going to open up a site in Pima County later in February," Ducey said. "But what's the consistent theme when you talk to anybody here ... we're going to say we need more inventory."

Christ said the state is looking at Coconino and Yuma counties to set up large vaccination sites similar to State Farm Stadium and Phoenix Municipal Stadium. They could possibly be state-run or a state-county hybrid, she said.

A site in Yuma would be welcome news for Phoenix resident Stephanie Parra, who was born and raised in Yuma. Her family still lives there, including her aunt, who is hospitalized and critically ill with COVID-19, and her parents, who have not received a vaccine yet.

"I know there is a great need. There is an entire state we have to worry about. But Yuma has been hit hard. I'm just frustrated. Why do we continue to forget about other parts of the state?" said Parra, a Phoenix Union High School District Board member who is the executive director of a Phoenix nonprofit organization.

"I want answers. They continue to say this (State Farm vaccination site) is a replicable, scalable model. I'd love a 24/7 site in Yuma. There's plenty of space — a lot of wide-open space. Yuma is not being given the attention it deserves. It is literally being devastated."

Yuma County has had the highest rate of COVID-19 infection in Arizona since the pandemic began, at 15,431 cases per 100,000 people as of Friday. The U.S. rate of COVID-19 infection as of Friday was 7,989 cases per 100,000 people.

Rural counties face unique challenges 

Some counties say their week-to-week allocations from the state vary widely, making it difficult to plan in advance and schedule appointments because the supply is not consistent or reliable. 

Yavapai County had administered more than 30,000 total doses, 90% of its supply, as of Friday, according to state data. It has one of the higher vaccination rates per 100,000 residents among Arizona counties.

But it's been a "turbulent process," Horton, the health director, said.

The county's first allocation from the state in late December was a "sizable" 8,200 doses, Horton said, allowing a quick start to vaccinating health care workers and other phase 1A individuals. But after that, weekly allocations have varied from 3,900 to 12,200 to 5,000 to 2,400, she said, some of which the county was able to bump up after requesting more from AZDHS. 

"We’ve had this very unsteady and ever-changing supply of vaccine each week," she said. "What’s tough from my perspective is that instability of supply for planning purposes. To maintain these operations on a rural level, we need to know that we have a consistent supply coming, or at least have some sort of outlook on that supply so that we can plan for it.”

» Read the complete article at link below:

The Arizona Department of Health Services said Friday it is expanding its COVID-19 vaccination programs, adding distribution at pharmacies and at a second state-run site in the East Valley and broadening the number of people eligible for the vaccine. Dr. Daniel Derksen, director of the Arizona Center for Rural Health at the University of Arizona, said it is important to remember that the state is up against tough odds. "I think that the logistics of carrying out a vaccination program in a state with a population over 7 million… is challenging," Derksen said.

• Cronkite News, 1/15/21
• Phoenix Business Journal, 1/15/21

» See PDF to view map and chart.

By Haleigh Kochanski/Cronkite News | Jan. 15, 2021

WASHINGTON – The Arizona Department of Health Services said Friday it is expanding its COVID-19 vaccination programs, adding distribution at pharmacies and at a second state-run site in the East Valley and broadening the number of people eligible for the vaccine.

The expansion comes as the state has already administered well over 200,000 doses of vaccine, which Dr. Cara Christ, health department director, called “an exciting milestone for Arizona.”

It also comes during a week in which the state posted the highest rate of new infections in the nation, according to the Centers for Disease Control and Prevention, with an average of more than 8,800 cases per day over the past seven days.

Christ outlined a broad expansion of the vaccination program, which had delivered 217,716 doses of the two approved COVID-19 vaccines, or about 36% of the more than 600,000 doses that have been delivered to the state.

“Any dose that remains in storage remains a challenge to be addressed, but as a state we are gaining momentum in protecting prioritized Arizonans from COVID-19,” Christ said in a prepared statementthis week.

Because of the limited amount of vaccine available so far, the state has prioritized availability, with health care workers and long-term care residents getting first crack at vaccinations, followed by teachers and first responders, then essential workers and adults with high-risk conditions. Eligible groups vary by county, some of which have already worked their way through the highest-priority residents.

Among the changes unveiled Friday by Christ is the addition of a new state-run vaccination site at Phoenix Municipal Stadium on Feb. 1, to complement a 24/7 site that has been operating since Tuesday at the State Farm Stadium in Glendale. More than 16,000 doses had been administered at the State Farm site as of Thursday.

Hours of operation at the Phoenix site have not been determined, but people will be able start making appointments there on Tuesday by visiting the patient portal on the Arizona Department of Health Services website.

Christ also said the state expects to add up to 100 pharmacies across the state that will be able to deliver the vaccine under the CDC’s Retail Pharmacy Program. That program could ultimately have as many as 800 pharmacies with COVID-19 vaccine available in the state.

The state is also relaxing restrictions on recipients in the Phase 1B priority list to include 65-year-olds, who can begin applying Tuesday for an appointment to get vaccinated. That category had previously been limited to those 75 and older, and lowering the age restriction could open vaccine availability to about 750,000 Arizonans.

The two currently approved vaccines – from Pfizer-BioNTech and Moderna – require two doses, which must be administered within weeks of each other to be effective. As of this week, 21,612 Arizonans had received both doses, according to the state health department.

Despite the recent gains, vaccine delivery in the state has not been without its hitches, including some conflicts between state and county software to register for a vaccination.

“It’s very poor planning on the state health department’s part,” Will Humble, director of the Arizona Public Health Association, said of the software problems.

Although state officials have hailed operations at the State Farm Stadium site, Humble said the state needs to do a better job of spreading the wealth.

“The vaccine has not gotten out in significant numbers to other decentralized sites,” he said. “At this rate, it’s going to take a lot longer.”

Arizona has delivered more doses of the vaccine than most other states, ranking 18th-highest in terms of total doses delivered, according to a COVID-19 tracker maintained by Bloomberg.

But the state does not fare so well when it comes to the delivery of doses per 100,000 residents. The CDC said Arizona’s rate of 2,708 doses administered per 100,000 residents ranked 45th among states.

Christ on Friday dismissed the CDC numbers, saying they do not reflect the most current data from the state. She said the Bloomberg data is much more timely. But while Bloomberg reported Friday that Arizona had administered a higher rate of 3.19 doses per 100 residents – or 3,190 per 100,000 – that still tied the state for 40th in the nation.

But Dr. Daniel Derksen, director of the Arizona Center for Rural Health at the University of Arizona, said it is important to remember that the state is up against tough odds.

“I think that the logistics of carrying out a vaccination program in a state with a population over 7 million … is challenging,” Derksen said Friday.

“I think the Arizona Department of Health Services has worked very closely with the 15 county health departments around the state to try to do this in a transparent … manner. The demand is enormous … we’re hoping that the distribution of vaccines will accelerate as we move forward.”

By Josh Ortega/Cronkite News | Dec. 21, 2020

WASHINGTON – After years of steady declines, enrollment in Affordable Care Act coverage ticked up in Arizona and held steady in the U.S. this year in what one advocate called a “pleasant surprise” after a challenging year.

The six-week open enrollment period that ended last Tuesday showed enrollment going from 153,020 in Arizona for coverage plans for this year to 154,265 people who signed up for coverage in 2021, according to preliminary numbers released Friday by the Centers for Medicare and Medicaid Services.

Nationally, the number of people signing up for coverage in the federal exchange dipped from 8.3 million last year to 8.2 million this year – but federal officials note that New Jersey and Pennsylvania shifted from the federal marketplace to state-based marketplaces this year. That removed 578,251 people from those states who would otherwise have been counted on the federal rolls.

CMS Administrator Seema Verma said in a statement Friday that the Trump administration’s “focus on delivering more choices along with a smooth and streamlined consumer experience continues to drive strong enrollment.”

“We’ve opened more pathways to enroll by taking advantage of the private sector and people are clearly finding the coverage they need at this critical time,” she said.

Morgan Tucker, state director for Protect Our Care Arizona, agreed that more people took advantage of coverage this year – but she said it was no thanks to the Trump administration, which she accused of trying to “sabotage” the Obama-era health insurance program.

“Despite anything they may have heard over the last four years, it is safe, reliable health insurance that they can trust,” Tucker said of coverage available under the “Obamacare” program.

The ACA has also been under assault by a coalition of states, including Arizona, that argued before the Supreme Court this fall that the plan is unconstitutional. A ruling in that case is not expected for months, but Tucker said it cast a shadow over this year’s open enrollment.

As in years past, the majority of enrollments came in the last week of the six-week open enrollment period – a much shorter time frame than was allowed in the first years of Obamacare.

More than half of this year’s total enrollment of 8.3 million came in the final 10 days, when 4.4 million people signed up, many of them returning customers, according to CMS data.

This is no surprise to Allen Gjersvig, director of outreach and enrollment services with the Arizona Alliance for Community Health Centers.

“Most enrollments in Arizona always take place after Thanksgiving,” he said. “It’s just the phenomenon.”

Dr. Daniel Derksen, associate vice president for Health Equity, Outreach and Interprofessional Activities at the University of Arizona Health Sciences, said he encourages every Arizonan to “take a look, shop and compare” coverage plans available through the ACA. It is especially important to do so in the face of the COVID-19 pandemic, he said.

“This could be a devastating, bankrupting experience when you need care, and you don’t have coverage,” Derksen said.

Tucker agreed that this “unique year” has proven why health insurance coverage is so crucial.

“I think it’s not a time to gamble with your health,” she said. “You might be young and healthy but that doesn’t make you invincible.”

She said the biggest hurdle during open enrollment this year was trying to get the word out to Arizonans through online events. She said that with a cut in funding for ACA outreach, her organization had to work hard to remind people about the dates for the open enrollment period, but even if someone missed the deadline there’s still options available to get coverage.

“It will come as no surprise that the federal government cut funding for open enrollment outreach, so it was all done through (online) events just trying to get the word out,” Tucker said.

Gjersvig the full picture for this year’s open enrollment won’t come out until January, but he’s optimistic. He also said he hopes the incoming administration of President-elect Joe Biden – who was vice president when Obamacare was enacted – will bring a public information campaign to clear up any misinformation about the ACA.

As for the Supreme Court, which heard arguments in the ACA case, California v. Texas, on Nov. 10, Derksen thinks “it’s highly unlikely that the entire Affordable Care Act will be invalidated.” The court upheld the law once already, in 2012, but the court has shifted to a conservative majority since then. Even if the court disagrees with part of the law now, however, Derksen doubts it will overturn the entire program.

“It seems unlikely that by repealing the tax penalty somehow invalidates the entire Affordable Care Act seems implausible,” he said.

Even though open enrollment ended on Dec. 15, Tucker said there is still a chance to enroll for people who were in line by the close of open enrollment or for people who have had life changes like a job loss or the birth of a child. And she urged people to do so if they can.

“If there’s ever a time where it’s crucial to have health insurance coverage, it’s right now,” she said.

By Josh Ortega/Cronkite News | Nov. 17, 2020

WASHINGTON – Arizona was in the bottom tier in three of six categories in a new American Lung Association report, which put the state dead-last for the number of patients who receive treatment after getting a diagnosis of lung cancer.

The 2020 “State of Lung Cancer” report released Tuesday also said Arizona ranked 46th among states for the number of patients who get surgery as a first course of treatment, and 44th for the number of people who get lung cancer screenings.

But the state was in the middle of the pack when it came to the early diagnosis of lung cancer and the five-year survival rate for people diagnosed with the disease.

And Arizona was among the best in the nation when it came to new lung cancer cases, with 47.1 new cases per 100,000 residents in the state compared to 57.8 per 100,000 nationally.

“The goal of the (report) is to empower the public to learn more about lung cancer in Arizona,” said JoAnna Strother, senior director of advocacy for the American Lung Association. “And to take action to improve lung cancer patient’s access to quality and affordable health care.”

One new aspect of the annual report is a breakdown of data by race and ethnicity. In almost every category, the report said minority groups were worse off than whites when it came to early diagnosis, treatment after diagnosis and surgical treatment. Asian Americans topped whites only in the area of surgical treatment, with the report saying they were 11% more likely to get surgical care.

Dr. Dan Derksen, associate vice president for Health Equity, Outreach & Interprofessional Activities at the University of Arizona Health Sciences, said racial and ethnic data jumped out to him because of Arizona’s relatively large Hispanic and Native American populations.

“Those populations are disproportionately affected for a number of reasons,” he said, including the cost of health insurance, as well as cost of and access to preventive health services.

The report said Latinos were 13% less likely than whites to get an early diagnosis, 2% less likely to get surgical care and 39% more likely to go without treatment after a diagnosis. Native Americans got an early diagnosis 14% less often than whites, got surgical treatment 19% less often and received any kind of follow-up treatment 15% less often.

Arizona was in the majority of states, along with 37 others, that cover lung cancer screening under the state’s Medicaid program. Derksen said that is a radical shift from when he first started in medicine.

“We didn’t screen for lung cancer because it was felt that it was such a lethal diagnosis,” he said. “Why screen for it, it wouldn’t change the outcomes.”

Derksen said that improvements in lung cancer have made the disease less of a “death sentence,” but the key remains screening for the disease to reduce mortality.

Strother agreed that “screening is the key to finding lung cancer early when it’s much more curable.”

She said overall the mission of this report is about bring awareness to those at higher risk of the disease, including people age 55 and older, current smokers or those who have quit in the past 15 years and “30 pack-year” smokers – someone who smoked a pack a day for 30 years, or two packs a day for 15 years.

Strother said those groups are eligible for a low-dose CT scan that could help with early detection, but few take advantage of it.

“Even though this simple screening test has been available since 2015, only 2.3% of those eligible in Arizona are actually being screened,” she said.

The national average was more than twice the Arizona rate, but still only a paltry 5.7% of those who were at high-risk had undergone screenings.

The report only looked at state Medicaid programs. Strother said if someone is looking into getting health insurance through the Affordable Care Act’s health care marketplace, they should do their research.

“It would really depend on the plan … and to make sure that screenings are covered through that,” she said.

Health experts said it’s hard to know how the COVID-19 pandemic will affect this screening, but the goal remains to educate people on what they currently know and the options available for screening.

“We’ll certainly improve things in Arizona if we’re able to get the information out, not only to individuals who are at risk, but also the health providers that treat them,” Derksen said.