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The Georgetown University Center for Children and Families (CCF) Rural Health Policy Project released Medicaid in Small Towns and Rural America: A Lifeline for Children, Families, and Communities. This report resulted from analysis by researchers from Georgetown and the University of North Carolina Rural Health Research Program and examined "how the role of Medicaid has changed over time in 46 states with small-town and rural populations."

The CCF also developed an interactive map that displays the percent of children in these areas covered by Medicaid in 2014-15.
https://ccf.georgetown.edu/map/the-percent-of-children-in-small-towns-and-rural-areas-covered-by-medicaid-201415/

By Stephanie Innes Arizona Daily Star | June 3, 2017 

An AARP television advertisement airing in Arizona again this week takes aim at federal health reform and is targeted to U.S. Sen. Jeff Flake. 

by Alexandria Bachert | Staff Writer, MedPage Today May 26, 2017

House Republicans and the White House have recently proposed massive reductions in the Medicaid program which could shave more than $1 trillion from projected expenditures over the next 10 years.

Much of the debate over these cuts has centered around the effects on children and the poor, but about 40% of the Medicaid budget pays for long-term care for the elderly, many of whom are poor only on paper. In this edition of “Friday Feedback,” experts discuss the critical role Medicaid plays in the healthcare system, particularly for America’s increasingly numerous seniors, and what might happen if funding is slashed.

…won't budget cuts simply deprive the poor of access to care?

Daniel Derksen, MD, Arizona Center for Rural Health: You don't save money by throwing millions off of coverage. That strategy shifts costs to states, to individuals and their families, and to physicians, hospitals, clinics and nurses through uncompensated and charity care. It strains credulity to cut almost a trillion dollars of federal funding to state Medicaid programs over the next 10 years, and claim that bill gives states more autonomy.

Tucson News Now | Wednesday, May 24, 2017, 8:45 pm

The National Rural Health Association (NRHA) honored Copper Queen Community Hospital (CQCH) CEO, James Dickson earlier this month with the 2017 Louis Gorin Award for Outstanding Lifetime Achievement in Rural Health Care.   

Award recipients are selected based on their creativity, unselfishness, compassion and cooperative attitude in seeking ways to make lasting contributions to rural health care.

“It is a rare opportunity for someone to be able to serve and help the community like I have for over 18 years, ” said James Dickson, “I would like to thank my staff, Board of Directors, and Physicians for believing in the vision and being able to provide access to primary healthcare in  medically underserved communities.”

Jim Dickson, has an unwavering commitment to providing rural southern Arizonans with accessible, affordable, high-quality health care. His efforts brought state-of-the-art care to southern Arizona through renovation and expansion of the hospital and RHC diagnostic and treatment services.

Dickson has achieved this through innovative and unparalleled collaborations with major health care systems in Arizona using telemedicine for sophisticated diagnostic and specialty care in Cochise County, saving residents the expense and travel to Tucson or Phoenix for services.

In addition to his work in health care, Dickson identifies and addresses unmet community needs, creating the first library for middle school students in Bisbee and offering scholarships to Cochise County high school graduates for training to land well-paying local jobs.

“Jim Dickson’s work at the CQCH critical access hospital and affiliated RHCs, and most recently, to create one of the state’s first rural freestanding emergency departments (ED) at the Douglas Medical Complex, underscores his unwavering commitment to providing rural southern Arizonans with accessible, affordable, high quality health care.” stated Daniel Derksen, MD from the Arizona Center for Rural Health at The University of Arizona.  

“For 20 years, Jim has led health care improvements in Cochise County that spans over 6,200 sq. miles, has a pop. density of 20 persons/sq.mi., and 17 percent poverty rate. For comparison, Connecticut is smaller at 5,500 sq.mi., has a pop. density of 650 persons/sq.mi. and 10.7 percent poverty rate.

His efforts brought state-of-the-art care to southern Arizona through renovation and expansion of the hospital and RHC diagnostic and treatment services.

He does this through innovative and unparalleled collaborations with major health care systems in Arizona using telemedicine for sophisticated diagnostic and specialty care in Cochise County, saving residents the expense and travel to Tucson or Phoenix for services.”

Arizona Week May 19, 2017 | Airs Fridays at 8:30 p.m. on PBS 6 | tv.azpm.org/azweek/
Episode 316: The Shape of Health Care in Arizona

A new health plan working through Congress, we ask what’s next for coverage in the Grand Canyon State? 

Video at link below:

KJZZ | By Will Stone | May 4, 2017

Almost all of Arizona’s Republicans threw their support behind the replacement for the Affordable Care Act, which narrowly passed the U.S. House on Thursday.

Four of Arizona’s five House Republicans voted for the American Health Care Act. Republican Rep. Andy Biggs, who represents a conservative district in the East Valley, joined Arizona's Democrats in opposing the bill.

Before the vote, Biggs criticized the legislation for not being a "clean repeal of Obamacare" and said he was disappointed that two amendments he had submitted were not adopted.

Even the state's Republican members of the House who voted for the bill struck a measured tone.

Congressman Paul Gosar, part of the far-right House Freedom Caucus, acknowledged the bill was not a full repeal, but said there were enough "conservative, time-tested" changes to this version of the AHCA to win his vote.

"Millions of Americans are drowning right now under the tidal wave of Obamacare regulations and mandates that have destroyed our entire health-care system. The American Health Care Act is a life raft to those suffering and represents a down payment towards a true market-based solution," Gosar said in a statement following the vote.

Congresswoman Martha McSally echoed those sentiments, saying she faced a "binary decision" and that the AHCA wasn't a "perfect bill."

“I will continue to work with state and local stakeholders and closely monitor this bill throughout the legislative and implementation process to ensure that my constituents have access to the care they need, that the most vulnerable are protected, and that Southern Arizona is better off in the future,” McSally said in a statement.

Congressmen David Schweikert and Trent Franks were the other Republicans from Arizona to vote yes.

The bill passed without a full analysis from the Congressional Budget Office, but some in Arizona's health-care industry say the new version of the AHCA will dramatically scale back Medicaid funding and, in the short term, cause premiums to rise for certain groups.

As written, the AHCA would allow states to apply for a waiver to what's known as the "community rating" requirement, which protected people with expensive medical conditions from being charged more than others.

"By removing that, insurance plans could charge people with pre-existing conditions significantly more to the tune where they could no longer be able to afford health insurance," Marcus Johnson of Vitalyist Health Foundation, which helps enroll people in Arizona's marketplace, said.

The AHCA allocates billions of dollars to help cover those with pre-existing conditions, but an initial analysis from Avalere Health shows that funding would not be nearly enough to cover everyone. Arizona has about 48,000 people with pre-existing conditions in its marketplace.

If Arizona pursues a waiver to establish a high-risk pool, Johnson said it's unclear whether Arizona would have the funding to cover the "demand of our aging and low-income population."

Arizona could also request exemptions from the "essential health benefits" that the ACA requires every insurance plan to include.

The Republican legislation also has major implications for Medicaid. It phases out the extra federal funding that Arizona received to expand the program.

More than 400,000 people in Arizona have joined the rolls of the state's Medicaid program since the state restored and expanded it. The new legislation keeps that enhanced funding for those already enrolled so long as they don't fall off the program, which is common among that population.

"This increases uncompensated care and forces hospitals to cost shift to commercial payers and businesses. There really isn't any free lunch in all of this," Debbie Johnston with the Arizona Hospital and Healthcare Association told KJZZ.

Johnston said the hospitals that won't be able to cost shift because of their payer mix may become financially unviable.

"We are deeply disappointed with the passage because it will jeopardize coverage for hundreds and hundreds of thousands of Arizonans," Johnston said.

"When you shift the risk and the blame from the federal government to states, it is going to make state government much more challenging with much less resources to do it," Dr. Daniel Derksen, director of the University of Arizona's Center for Rural Health, said about the changes to Medicaid.

"This isn't increasing or preserving choices. This is really reducing choices," Derksen said.

Along with rolling back the expansion, the AHCA changes Medicaid from an open-ended federal program to one that's capped. That most likely means less money for a state like Arizona, which already has a low-cost program. 

Dr. Jeffrey Singer, who’s a surgeon in the Valley and a fellow at the Cato Institute, said that’s a good thing.

“By freeing states from the shackles of Washington, that money can go a lot farther. States need to be able to control their budgets because the way Medicaid is growing, it’s not leaving room for anything else,” Singer said.

In response to the vote, a spokesperson for Governor Doug Ducey emphasized that the legislation is still a work in progress: