Arizona’s measure could be a model for Democrats nationwide

Local advocacy groups in several states that have passed progressive ballot measures in recent years — such as Arkansas, Missouri and Oklahoma — have expressed interest in launching their own medical debt campaigns, according to the Fairness Project, which supports the adoption of progressive policies through the referendum process. .

“This model of protecting more working families from the impacts of even small amounts of debt will be a big part of what we see go to the ballot in the next cycle or two,” said Kelly Hall, executive director of the Fairness Project.

The November measure comes as state-level health care advocates grapple with how to help residents deal with rising health care costs now that it appears Congress won’t be able to to adopt significant reforms to solve the problem. Nearly one in 10 adults in the United States have medical debt, including 3 million who owe more than $10,000, according to an analysis by the Kaiser Family Foundation.

Democratic state lawmakers have passed legislation in recent years to address health care costs through public health insurance options, health care cost commissions and debt reform. medical. Last year, California, Colorado, Illinois, Maryland, Nevada and New Mexico passed bills dealing with medical debt.

In April, the Biden administration sought to tackle medical debt by directing federal agencies to eliminate medical debt as a factor in accessing federal resources, streamlining veterans’ debt relief, and targeting through the Consumer Financial Protection Bureau unscrupulous debt collectors attempting to collect a debt that has already been paid or posing as law enforcement.

An estimated 875,000 Arizonans — about 12% of the state — have medical bills in collection, with a median debt of $719, according to an Urban Institute analysis.

If passed, creditors will not be allowed to charge more than 3% interest on medical debt, up from 10% previously. It will also increase the value of a debtor’s creditor-protected home from $250,000 to $400,000 and decrease the portion of a debtor’s weekly disposable income subject to collection from 25% to 10%.

« We just don’t think anyone should lose their home or their car, their means of getting to work and earning a living because of a medical bill they can’t pay, » said Rodd McLeod, spokesperson for Healthcare Rising Arizona, which is supporting the ballot measure. « A measure like this is an attempt to try to create respite for families struggling with debt. »

Opponents — who by and large represent creditors — argue the proposal is too broad because the asset-protecting provisions would apply to all forms of debt, not just medical debt, a move they say , will devastate the government loan market. The Arizona Chamber of Commerce and Industry, the Arizona Bankers Association and the Arizona Free Enterprise Club are among the organizations opposing the measure.

« It’s marketed as a medical debt initiative but still impacts all collection remedies at all levels, » said Amber Russo, spokeswoman for Protect Our Arizona, which opposes the ballot measure. « My concern with this issue is that it’s a bridge too far. »

Protect Our Arizona also took aim at the fact that the Arizona measure is funded by SEIU-UHW, the California health care union that created the Fairness Project in 2015 to push progressive ballot measures across the country. and most recently supported Healthcare Rising Arizona to organize Arizona healthcare workers and patients around healthcare reform.

SEIU-UHW and Healthcare Rising Arizona injected approximately $8 million in cash and in-kind contributions at the end of September into Arizonans Fed Up with Rising Healthcare, the primary PAC supporting the measure. Opponents have used the numbers to argue that a ‘deep-pocketed’ California union is ‘buying legislation’ – mirroring complaints made especially by conservatives across the country about other progressive ballot measures.

“It feels so crass to me because it feels like buying legislation,” Russo said.

The union did not respond to multiple requests for comment, but supporters of the measure in the state, including Kelly Griffith, CEO of the Tucson-based Center for Economic Integrity, said the union for the first time allowed debt reform advocates to be proactive at the polls instead of reactive, as the group was when it mounted a defense against a payday loan measure in 2008.

“Supporting .209 is actually an offensive effort that our small organization alone wouldn’t have the financial resources to tackle,” Griffith said.

Other supporters include the Arizona Public Health Association, the Southern Arizona AIDS Foundation and several local unions.

Protect Our Arizona, on the other hand, raised about $530,000, much of it from the Arizona Creditor Bar Association. Opponents of the election measure on the ground in Arizona say the big banks who might be able to help their cause haven’t shown much interest in the measure.

“Do the big banks exist in the financial sector? Sure. But I think you have so much more risk tolerance at the top level that they’re going to wait and see what happens,” Russo said. « Maybe the moment it hits Colorado or Michigan or Illinois, they’ll go, ‘Uh-oh, look at this trend.' »

The ballot measure hasn’t garnered as much attention as Arizona’s high-profile races for governor and senator, where polls show both races remain up for grabs. But as National Democrats struggle to talk about inflation and the economy, the political landscape could give the Arizona ballot measure a further boost as voters remain highly cost-conscious heading into the ballot boxes.

“We don’t take anything for granted in any election, especially not in a state like Arizona. That said, it’s a very intuitive and simple problem for voters to understand,” said Hall, executive director of the Fairness Project. « The feedback from the electorate, as we can gather so far, indicates that there is overwhelming support for this issue across all parties and across the state, so we are very excited about the outcome. «

Opponents argue the measure will do nothing to reduce underlying health care costs, noting that no health care organizations, including the state’s largest hospitals, have spoken out against the measure. . But health care experts say the ballot measure could help people cope with some long-term consequences of unpaid medical bills.

« These efforts help people with medical debt free up monthly finances and provide some relief, but it doesn’t make people’s medical bills go away or it doesn’t make health care cheaper, » Krutika said. Amin, associate director. to the Kaiser Family Foundation program on ACA. « While that helps people free up finances, there’s also this health care affordability issue. »

Eva Marie Stahl, vice president of public policy at RIP Medical Debt, a nonprofit that buys people’s medical debt so they don’t have to pay it, acknowledged that the measure only solves a part of the overall medical debt problem, but said, « It’s worth chewing gum and walking at the same time.

« It’s a really new approach, and it parallels campaigns to expand Medicaid, » said Stahl, whose nonprofit endorsed the measure. “It’s a useful way to start a conversation with the public about medical debt. It’s really easy to understand. It affects everyone. Even though we say this is a racial justice issue, and that’s because it disproportionately affects black households in particular, it’s an issue for everyone.