REFERENCE TITLE: single payor health program State of Arizona Senate Fifty-seventh Legislature First Regular Session 2025 SB 1426 Introduced by Senator Ortiz An Act amending title 36, Arizona Revised Statutes, by adding chapter 42; relating to health care. (TEXT OF BILL BEGINS ON NEXT PAGE)
REFERENCE TITLE: single payor health program
State of Arizona Senate Fifty-seventh Legislature First Regular Session 2025
SB 1426
Introduced by Senator Ortiz
REFERENCE TITLE: single payor health program
State of Arizona
Senate
Fifty-seventh Legislature
First Regular Session
2025
SB 1426
Introduced by
Senator Ortiz
An Act
amending title 36, Arizona Revised Statutes, by adding chapter 42; relating to health care.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona: Section 1. Title 36, Arizona Revised Statutes, is amended by adding chapter 42, to read: CHAPTER 42 ARIZONA HEALTH PROGRAM ARTICLE 1. ARIZONA HEALTH PROGRAM START_STATUTE36-4201. Definitions In this chapter, unless the context otherwise requires: 1. "Administration" means the arizona health care cost containment system administration. 2. "Arizona HEALTH program" or "program" means the program established pursuant to section 36-4202. 3. "Board" means the board of trustees of the Arizona HEALTH program. 4. "Director" means the director of the Arizona health care cost containment system. 5. "Enrollee" means an individual who is enrolled in the program. 6. "Health care provider" means any individual or entity that is licensed by this state to provide health care services. 7. "HEALTH care service" means any health care service that is included as a benefit under the program. 8. "Participating provider" means any health care provider that is contracted under this article to provide health care services to enrollees of the program. 9. "Resident" means an individual whose primary place of residence is in this state or who is employed or self-employed full time in this state. END_STATUTE START_STATUTE36-4202. Arizona health program; eligibility; enrollment A. The Arizona HEALTH PROGRAM is established in the Arizona HEALTH care cost containment system. The director shall implement the program pursuant to this article. B. The program shall provide comprehensive health benefit coverage to each resident who enrolls in the program. Each resident of this state is eligible and entitled to enroll in the program. A newborn child is enrolled as of the date of the child's birth if the enrollment is done before the child's birth or within sixty days after the child's birth. C. An enrollee is not required to pay any premium or other charge for enrolling in or receiving benefits under the program. D. This article does not require a resident to enroll in the program or prohibit a resident from purchasing health insurance from a private health insurer. END_STATUTE START_STATUTE36-4203. Board of trustees; appointment; trustee reimbursement A. The ARizona health program board of trustees is established and shall be composed of: 1. The director of the Arizona health care cost containment system or the director's designee. 2. The director of the department of revenue or the director's designee. 3. The director of the department of insurance and financial institutions or the director's designee. 4. Thirty-one board trustees who are appointed by the governor, including: (a) Six board trustees who are representatives of health care consumer advocacy organizations that have a statewide or regional constituency and who have been involved in issues of interest to low and moderate-income individuals, older adults and people who have disabilities. (b) At least three board trustees who represent organizations led by consumers in those groups. (c) Three board trustees who represent professional organizations representing physicians in this state. (d) Five board trustees who represent professional organizations representing licensed or certificated health care professionals in this state other than physicians. (e) Three board trustees who represent hospitals in this state, One of whom represents community health centers. (f) Two board trustees who represent rehabilitation or home health care providers in this state. (g) Two board trustees who represent behavioral or mental health or disability service providers in this state. (h) Three board trustees who represent organized labor in this state. (i) Two board trustees who have demonstrated expertise in health care finance. (j) two board trustees who are employers or representatives of employers who pay the payroll tax under this article or who will pay the tax under this article. 5. Five board trustees who are appointed by the speaker of the house of representatives. 6. Five board trustees who are appointed by the president of the senate. 7. Two board trustees who are appointed by the minority leader of the house of representatives. 8. Two board trustees who are appointed by the minority leader of the senate. B. After the program has been implemented, a person may not be a board trustee unless the person is an enrollee of the program. C. Each board trustee shall serve at the pleasure of the appointing officer, except the ex officio trustees. D. The chairperson of the board of trustees shall be appointed by the governor from among the board trustees. The board shall meet at least four times each calendar year. Meetings shall be held on the call of the chairperson and as provided by the board. A majority of the appointed board trustees constitutes a quorum of the board. The affirmative vote of a majority of the board trustees voting, but not less than twelve, is necessary for any action to be taken by the board. The board may establish an executive committee to exercise any powers or duties of the board as it may provide and other committees to assist the board or the executive committee. The chairperson of the board shall serve as chairperson of the executive committee and shall appoint the chairperson and members of all other committees. The board may appoint one or more advisory committees, who need not be members of the board. E. Board trustees shall serve without compensation but are eligible to receive reimbursement of expenses pursuant to title 38, chapter 4, article 2. END_STATUTE START_STATUTE36-4204. Board duties; benefit coverage plan; cost analysis; revenue proposal A. Not later than twelve months after the effective date of this article the board shall develop proposals for the benefit coverage plan under the program that includes all health care services required to be covered under any of the following, regardless of whether an enrollee would otherwise be eligible for or covered by the program or benefit: 1. The arizona health care cost containment system pursuant to chapter 29, article 1 of this title. 2. The Arizona long-term care system PURSUANT TO chapter 29, article 2 of this title. 3. The children's health insurance program pursuant to chapter 29, article 4 of this title. 4. The state employee HEALTH benefits program. 5. the Arizona state retirement system retiree health care plans. 6. Medicare. B. During the development of the benefit coverage plan, the board, in coordination with the director, shall identify any waivers from the centers for medicare and medicaid services or any other federal agency that are necessary to avoid jeopardizing federal financial participation in any federally subsidized program administered by this state. C. After the board adopts the benefit coverage plan for the program, the board shall conduct an analysis of the costs of the benefit coverage plan. The board may contract with a third party for THE benefit coverage plan cost analysis. D. After the benefit coverage cost analysis is completed, the board, in coordination with the governor's office, shall develop a revenue proposal to pay for the program that includes at least the following components: 1. The implementation of a payroll tax that would apply to wages and self-employment income of each resident of this state regardless of whether the resident is enrolled in the program. 2. A progressive structure that would require a resident who earns a higher income to pay a higher rate. 3. An exemption for the first $25,000 of wage income. 4. A requirement that an employer pays at least eighty percent and the employee pays twenty percent, without prohibiting an employer from paying up to one hundred percent. 5. The imposition of a new income tax for all other categories of income that would require a resident who earns a higher income to pay a higher rate, exempting the first $25,000 of income. 6. An exemption for medicare enrollees for the first $50,000 of income, regardless of the source. E. The board shall adopt the completed revenue proposal. END_STATUTE START_STATUTE36-4205. Administration; rules; health care providers; payment A. The administration shall adopt rules to administer the program, including: 1. qualifications and requirements of the health care providers participating in the program. The administration shall contract directly with any qualified health care provider that wishes to participate in the program. 2. Payment methodologies for health care services provided to enrollees under the program by participating providers. 3. Quality of care standards for the program. B. The administration may not contract with health insurers or other third-party payors or administrators to manage the health care services provided to enrollees. C. Payment for health care services to a participating provider under the program is considered full payment for the health care service. A participating provider may not charge a rate in excess of the payment established PURSUANT TO this section. END_STATUTE START_STATUTE36-4206. Revenue proposal submittal; legislative adoption; implementation of program A. The governor shall submit the revenue proposal developed pursuant to section 36-4204 as part of the executive budget in the budget submission following the board's adoption of the revenue proposal. B. The administration may not implement the program until the legislature adopts the revenue proposal or an equivalent proposal that will pay for the full cost of the program within the required components specified in section 36-4204, subsection D. END_STATUTE
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 36, Arizona Revised Statutes, is amended by adding chapter 42, to read:
CHAPTER 42
ARIZONA HEALTH PROGRAM
ARTICLE 1. ARIZONA HEALTH PROGRAM
START_STATUTE36-4201. Definitions
In this chapter, unless the context otherwise requires:
1. "Administration" means the arizona health care cost containment system administration.
2. "Arizona HEALTH program" or "program" means the program established pursuant to section 36-4202.
3. "Board" means the board of trustees of the Arizona HEALTH program.
4. "Director" means the director of the Arizona health care cost containment system.
5. "Enrollee" means an individual who is enrolled in the program.
6. "Health care provider" means any individual or entity that is licensed by this state to provide health care services.
7. "HEALTH care service" means any health care service that is included as a benefit under the program.
8. "Participating provider" means any health care provider that is contracted under this article to provide health care services to enrollees of the program.
9. "Resident" means an individual whose primary place of residence is in this state or who is employed or self-employed full time in this state. END_STATUTE
START_STATUTE36-4202. Arizona health program; eligibility; enrollment
A. The Arizona HEALTH PROGRAM is established in the Arizona HEALTH care cost containment system. The director shall implement the program pursuant to this article.
B. The program shall provide comprehensive health benefit coverage to each resident who enrolls in the program. Each resident of this state is eligible and entitled to enroll in the program. A newborn child is enrolled as of the date of the child's birth if the enrollment is done before the child's birth or within sixty days after the child's birth.
C. An enrollee is not required to pay any premium or other charge for enrolling in or receiving benefits under the program.
D. This article does not require a resident to enroll in the program or prohibit a resident from purchasing health insurance from a private health insurer. END_STATUTE
START_STATUTE36-4203. Board of trustees; appointment; trustee reimbursement
A. The ARizona health program board of trustees is established and shall be composed of:
1. The director of the Arizona health care cost containment system or the director's designee.
2. The director of the department of revenue or the director's designee.
3. The director of the department of insurance and financial institutions or the director's designee.
4. Thirty-one board trustees who are appointed by the governor, including:
(a) Six board trustees who are representatives of health care consumer advocacy organizations that have a statewide or regional constituency and who have been involved in issues of interest to low and moderate-income individuals, older adults and people who have disabilities.
(b) At least three board trustees who represent organizations led by consumers in those groups.
(c) Three board trustees who represent professional organizations representing physicians in this state.
(d) Five board trustees who represent professional organizations representing licensed or certificated health care professionals in this state other than physicians.
(e) Three board trustees who represent hospitals in this state, One of whom represents community health centers.
(f) Two board trustees who represent rehabilitation or home health care providers in this state.
(g) Two board trustees who represent behavioral or mental health or disability service providers in this state.
(h) Three board trustees who represent organized labor in this state.
(i) Two board trustees who have demonstrated expertise in health care finance.
(j) two board trustees who are employers or representatives of employers who pay the payroll tax under this article or who will pay the tax under this article.
5. Five board trustees who are appointed by the speaker of the house of representatives.
6. Five board trustees who are appointed by the president of the senate.
7. Two board trustees who are appointed by the minority leader of the house of representatives.
8. Two board trustees who are appointed by the minority leader of the senate.
B. After the program has been implemented, a person may not be a board trustee unless the person is an enrollee of the program.
C. Each board trustee shall serve at the pleasure of the appointing officer, except the ex officio trustees.
D. The chairperson of the board of trustees shall be appointed by the governor from among the board trustees. The board shall meet at least four times each calendar year. Meetings shall be held on the call of the chairperson and as provided by the board. A majority of the appointed board trustees constitutes a quorum of the board. The affirmative vote of a majority of the board trustees voting, but not less than twelve, is necessary for any action to be taken by the board. The board may establish an executive committee to exercise any powers or duties of the board as it may provide and other committees to assist the board or the executive committee. The chairperson of the board shall serve as chairperson of the executive committee and shall appoint the chairperson and members of all other committees. The board may appoint one or more advisory committees, who need not be members of the board.
E. Board trustees shall serve without compensation but are eligible to receive reimbursement of expenses pursuant to title 38, chapter 4, article 2. END_STATUTE
START_STATUTE36-4204. Board duties; benefit coverage plan; cost analysis; revenue proposal
A. Not later than twelve months after the effective date of this article the board shall develop proposals for the benefit coverage plan under the program that includes all health care services required to be covered under any of the following, regardless of whether an enrollee would otherwise be eligible for or covered by the program or benefit:
1. The arizona health care cost containment system pursuant to chapter 29, article 1 of this title.
2. The Arizona long-term care system PURSUANT TO chapter 29, article 2 of this title.
3. The children's health insurance program pursuant to chapter 29, article 4 of this title.
4. The state employee HEALTH benefits program.
5. the Arizona state retirement system retiree health care plans.
6. Medicare.
B. During the development of the benefit coverage plan, the board, in coordination with the director, shall identify any waivers from the centers for medicare and medicaid services or any other federal agency that are necessary to avoid jeopardizing federal financial participation in any federally subsidized program administered by this state.
C. After the board adopts the benefit coverage plan for the program, the board shall conduct an analysis of the costs of the benefit coverage plan. The board may contract with a third party for THE benefit coverage plan cost analysis.
D. After the benefit coverage cost analysis is completed, the board, in coordination with the governor's office, shall develop a revenue proposal to pay for the program that includes at least the following components:
1. The implementation of a payroll tax that would apply to wages and self-employment income of each resident of this state regardless of whether the resident is enrolled in the program.
2. A progressive structure that would require a resident who earns a higher income to pay a higher rate.
3. An exemption for the first $25,000 of wage income.
4. A requirement that an employer pays at least eighty percent and the employee pays twenty percent, without prohibiting an employer from paying up to one hundred percent.
5. The imposition of a new income tax for all other categories of income that would require a resident who earns a higher income to pay a higher rate, exempting the first $25,000 of income.
6. An exemption for medicare enrollees for the first $50,000 of income, regardless of the source.
E. The board shall adopt the completed revenue proposal. END_STATUTE
START_STATUTE36-4205. Administration; rules; health care providers; payment
A. The administration shall adopt rules to administer the program, including:
1. qualifications and requirements of the health care providers participating in the program. The administration shall contract directly with any qualified health care provider that wishes to participate in the program.
2. Payment methodologies for health care services provided to enrollees under the program by participating providers.
3. Quality of care standards for the program.
B. The administration may not contract with health insurers or other third-party payors or administrators to manage the health care services provided to enrollees.
C. Payment for health care services to a participating provider under the program is considered full payment for the health care service. A participating provider may not charge a rate in excess of the payment established PURSUANT TO this section. END_STATUTE
START_STATUTE36-4206. Revenue proposal submittal; legislative adoption; implementation of program
A. The governor shall submit the revenue proposal developed pursuant to section 36-4204 as part of the executive budget in the budget submission following the board's adoption of the revenue proposal.
B. The administration may not implement the program until the legislature adopts the revenue proposal or an equivalent proposal that will pay for the full cost of the program within the required components specified in section 36-4204, subsection D. END_STATUTE