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November 29, 2011

Host: Ted Simons

Arizona Health Insurance Exchange

  |   Video
  • Arizona has received a $30 million federal grant to create a health insurance exchange to help individuals and small businesses find affordable health insurance. The Governor’s Director of Health Care Policy, Don Hughes, explains how the money will be used.
  • Don Hughes - Director of Health Care Policy for the Governor
Category: Medical/Health   |   Keywords: AZ, health, exchange,

View Transcript

Ted Simons: In other news, Arizona received a $30 million federal grant today to establish a program to help individuals obtain health insurance. Arizona has not committed to establish the program, and if it chooses not to, the federal government may step in and open one anyway. Arizona is also among a handful of states challenging the constitutionality of reform law. Here to talk about what the money means to Arizona is Don Hughes, the Governor’s Health care Policy Advisor. Good to have you here, thanks for joining us.

Don Hughes: Thank you, Ted.

Ted Simons: What is that money going to be used for?

Don Hughes: What the money is going to be used for, Ted, we're going to continue planning for implementing a health insurance exchange in Arizona. What a health insurance exchange is very simply, it's Travelocity for health insurance. It's a website and call center and the I.T. infrastructure that goes along with that, that will allow people to find the health insurance that meets both their health needs and is affordable to them and simply make it easier for people to buy commercial insurance for small employers, to offer more affordable choices to employees and allow people to enroll into our public programs like AHCCCHS, food stamps and TANIF.

Ted Simons: So in exchange, offers health plans, determines eligibility for a variety of things, health plans, medication, the whole nine yards, and allows for enrollment online. That's what these health care exchanges do?

Don Hughes: Yes.

Ted Simons: Okay. $30 million comes to us for what? Just to get the thing off the ground?

Don Hughes: What the money will be used for, Ted, is to continue some of the additional planning we need to do to implement a health insurance exchange, and to begin the development of the I.T. infrastructure, which is the heart of the exchange. This is not the kind of simple I.T. project where you can call the guys from best buy to come out in an hour on a Saturday and put it together for you. It's an incredibly complex I.T. project that has to communicate with a federal data hub, with AHCCCHS, with DES, the department of insurance, health plans on the exchange. Make determinations on eligibility for AHCCCHS and tax credits on a real-time basis, and make it a consumer experience that is similar to what you would experience on Travelocity or Expedia or

Ted Simons: The impact of exchanges on the uninsured, what do you see for Arizona?

Don Hughes: Based on research we did, during the planning phase that has just ended, we believe we can reduce Arizona's uninsured rate of 19% where it stands today, to 11%, that we could add probably 500,000 people or more to either commercial or public insurance through the AHCCCHS program.

Ted Simons: With that in mind, how much flexibility will the state have in figuring out the best way to go ahead and run, manage, use these exchanges?

Don Hughes: Well, it is a federal law. So there are certain requirements within the law and within the federal regulations that go along with that. But states have an awful lot of flexibility in designing the exchange. For example, you can have what's referred to as an active purchaser model, where the state goes out and contracts with a handful of companies. Or you can take the approach that Arizona favors, of an open market that any health insurer that meets the minimum federal requirements to sell on the exchange, who wants to sell, will be allowed to. Our position is, we want to maximize the amount of choice and competition in the insurance market. We want to give small employers and individuals as many choices as they can possibly have, but give them the decision support tools to narrow those choices down to the three or four or five that really make sense for them.

Ted Simons: Arizona has sent a very strong signal from the governor on down of its dissatisfaction with federal health care reform. And the idea of these exchanges in the first place, having to go through the process, why did we get the money when there is so much negativity coming from Arizona?

Don Hughes: Well, Governor Brewer believes the law is unconstitutional. We joined the multistate litigation that's currently before the U.S. Supreme Court. They have scheduled oral arguments for February and March of 2012. We will expect a decision by June or July of 2012. But we don't know what that 5 decision is going to be. So if -- the Governor believes it is simply prudent and in Arizona's best interests to continue the planning process. So if we have to have an exchange, should that part of the law be upheld, it is better for Arizona to design and operate an exchange we believe is best for Arizona, rather than defer to the federal government.

Ted Simons: Last point, many in her own party say they don't want Arizona to be a part to this at all. They want absolutely nothing to do with this. It seems you don't really have a choice, you do it yourself or someone's going to do it for you.

Don Hughes: Exactly. If the law is upheld as constitutional by the Supreme Court, either the state can do it or the federal government can do it, but there will be one beginning with the open enrollment period of October 1st, 2013. There will be an exchange in Arizona. We believe that it is better to hope for the best and plan for the worst so. That we're prepared to run an Arizona exchange based on free market principles.

Ted Simons: Good to have you here.

Don Hughes: Thank you.

Arizona Town Hall: Energy

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  • ASU Senior Sustainability Scientist Clark Miller discusses recommendations from the recent Arizona Town Hall on “Arizona’s Energy Future”.
  • Clark Miller - ASU Senior Sustainability Scientist
Category: Sustainability   |   Keywords: town, hall, energy, future,

View Transcript
Ted Simons: Energy was the question earlier this month at the Grand Canyon, a diverse group of Arizona residents met to try to reach consensus on recommendations for Arizona's energy future. Here to tell us about all this is Professor Clark Miller for science policies and outcomes at ASU. He helped put together the background report that guided the discussion. Thanks for joining us tonight.

Clark Miller: Thank you.

Ted Simons: As far as Arizona's energy resources what are we looking at here?

Clark Miller: One of my colleagues is fond of saying Arizona is something of an energy desert, in the sense that we don't have a lot. There are some resources in the northern part of the state but for the most part we import most of our energy fuels, coal, oil, natural gas. But we do have a potential energy resource that is nearly the best in the country, and that is our solar energys. We all know the sun shine as lot.

Ted Simons: With that in mind, you said earlier the impact of energy. The impact of the energy on the state's economy?

Clark Miller: It's enormous. One component is the direct affect of energy on the economy, apf, they are enormous employers. If you begin to go into some of the smaller utilities, a big chunk of economy, $10 million a year is part of the energy economy. We spend a lot of money on energy, $17 billion a year Arizona businesses and consumers pay. Most of it goes out of state because we're importing fuel. On the other hand there's the indirect effects, which is to say you can't run an economy without energy, just period. You can’t do anything in a modern society without energy.

Ted Simons: Which means you need a comprehensive plan. I would imagine just getting a comprehensive plan was discussed at the town hall. Talk to us about that and the kind of principles that need to be applied when talking about the future of energy in Arizona.

Clark Miller: So we talked a lot about the idea of a comprehensive energy plan for several reasons. One is we're, like most of the country, indeed most of the world, at something of a crossroads with respect to energy. We all know gas prices have been rising, energy prices in general are rising. We know there are environmental and sustainability issues associated with our energy systems. So there's an opportunity to look forward and really chart a future. And the town hall made a strong recommendation for a comprehensive energy plan that would -- and I think this is important -- set us on a path towards sustainability by mid century for the state's energy resources and energy development. There was quite a consensus behind that. Of course, sustainability is not the only thing one wants to care about. Accessibility, affordability are critical questions going forward, security, as well. But what we know at the moment is that both on security and sustainability, the current energy system doesn't meet what it needs to meet for our long-term, both the livelihoods the people in the state and the economic prosperity.

Ted Simons: What about environmental concerns?

Clark Miller: So you have a variety of environmental concerns that were discussed at town hall that people feel are important. One obviously is local air pollution, both in our urban areas and in our rural areas. And of course the long-term question that people are asking about is global warming and climate change and the impact of carbon emissions.

Ted Simons: Was there consensus among the folks at town hall regarding renewable energy, that the state is on the right path with renewable? Did they want to see more of a commitment, not so much of a commitment? What did you hear?

Clark Miller: There was a fairly broad consensus about the need for more renewable energy. The discussion tended to go between folks who wanted to emphasize that we need to go modestly and slowly with adding new renewables, that there are real challenges and there are with adding substantial amounts of renewables to the portfolio mix. Against those who saw this as a real economic opportunity for the State, an opportunity to take a leading role is not only the production of solar energy, but also the manufacturing of the equipment that you need to take advantage of it.

Ted Simons: How did affordability make its way into the discussion? Whenever we talk about solar in a serious way, affordability rears its head.

Clark Miller: You have two issues with respect to affordability that are important. One is maintaining affordability, especially for those at the lowest income levels of the population. And that's a real issue that we have to grapple with as we go forward in making sure that we continue to be able to serve those folks with affordable energy. But the other dimension of affordability that comes in is that solar is increasingly cost competitive in many markets -- well, maybe not many, but at least in some markets at the moment solar has already reached what we call good parity. It's no more expensive than other population options that we have available. In other areas, like computers, think of solar panels. They are made of the same silicon as computer chips. And just like computers, they have rapid price declines. Solar panels are on the same curve.

Ted Simons: Are we looking at energy for our own needs, are we looking at providing for others?

Clark Miller: This is one of the big questions that I think faces the state. As we put a comprehensive plan together, the state's citizens are going to have to make that choice. If we're talking about ourselves that would be a significant undertaking but one that would be 1% of the undertaking that would be involved in providing substantial solar energy for the rest of the country. On the other hand, I think it's fairly clear that the rest of the country is not going to be on a long-term sustainable energy path unless Arizona steps up to the plate. The electric power research institute, which is the industry research body for the electricity utility industry, recently came by ASU and in their renewable energy scenario for the country as a whole, they have Arizona producing 100 gigawatts of solar energy by 2100. That's a huge amount of energy that would require significant land resources to be put in solar farms and so forth.

Ted Simons: What do we take from town hall? What kind of recommendations do you think need to be highlighted? We've got about a minute left. What do we take from all this?

Clark Miller: Well, I think three things. One is that the state needs to put itself on a sustainable energy path and that's going take a lot of work by the political leadership, the business leadership, and really the civic leadership, citizens of the state. The second that is we have a real economic opportunity, and that the town hall recommendation was to take advantage of that opportunity, create jobs, create revenues in the state and reduce our requirement to spend money out of state for those energy resources. The third is really develop this comprehensive energy plan. It won't be easy, it'll take a lot of work. Particularly when you're looking at an industry, the utility side and the people building solar farms, all of them want consistency. That's their number one message at town hall, consistency of policy. And the plan could do that.

Ted Simons: Good stuff. Clark, thanks for joining us.

Clark Miller: Thank you.

Ted Simons: Tomorrow on "Horizon," Maricopa County supervisors discuss challenging facing Arizona communities and their priorities for the next legislative session. That's Wednesday at 7:00 on "Horizon." Thanks for joining us, you have a great evening.

Education Empowerment Savings Accounts

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  • Attorneys on opposite sides of a lawsuit challenging the constitutionality of Arizona’s education empowerment savings accounts make their cases for and against the program.
  • Clint Bolick - Goldwater Institute
  • Chris Thomas - Arizona School Boards Association
Category: Education   |   Keywords: education, funding,

View Transcript
Ted Simons: A new state law that allows public money to be used to send disabled kids to private or religious schools is unconstitutional according to organizations that are challenging the law in court. Earlier this year state lawmakers established education empowerment scholarships for disabled students who leave public schools to seek an education elsewhere. Those students are eligible to receive about 90% of what the State would have spent to educate them in public school. Courts have struck down similar programs in the past. Proponents say this one is different. Both sides argued their cases in a hearing in Superior Court. Joining me is Chris Thomas, for one of the groups challenging education empowerment scholarships. And Clint Bolick, an attorney from the Goldwater Institute that is defending the program. Thanks for joining us us.

Ted Simons: This is different from tuition tax credits and vouchers how?

Clint Bolick: Tuition tax credits were upheld, vouchers were struck down. You can use the money for a wide variety of educational purposes, even if you educate your child at home. You can purchase tutoring, therapeutic services. You can get online education. Not a single dollar of the money is necessarily earmarked for private schools. And that is what the constitution forbids.

Ted Simons: The idea that it's money goes to parents, the parents get to decide as opposed to having a limited menu option.

Chris Thomas: That's the theory that was rejected by the Arizona Supreme Court. The fact that the parents direct the money does not necessarily make it constitutional under the Arizona constitution. If there is public money going to a religious private school or even a private school under our constitution, it's unconstitutional. That's what the court held. We don't think these are very different than the vouchers found unconstitutional.

Ted Simons: You're saying it doesn't matter how it gets there, if the public money gets to a private or a religious school.

Chris Thomas: Whether in a direct or indirect fashion, the Kane court says it doesn't matter. The Constitution doesn't hold any water.

Clint Bolick: What's really ironic, apart from the troubling aspect of school boards using taxpayer money to challenge this program in the first place, when they say they don't have enough money for their core duties, apart from that, the State of Arizona already sends thousands of disabled students to private schools under the federal individuals with disabilities education act. They pay the full tuition up to $35,000, $40,000. The other side says, oh, but these remain public students. The constitution doesn't make an exception for that. The key thing here, what the Supreme Court said is that if the state is writing a check to a private school that's impermissible, it's not doing that here. And the parents have no choices except private schools, it's impermissible. That's not the case here.

Chris Thomas: It's very different because the students are still enrolled in a public school. The students still have all of the rights that they would have under the individuals with disabilities in education act. They still have to go through the individual educational plan team to decide whether or not they deserve private placement, if their situation warrants it. It is different. And as to Clint's point about the school board association, we care about public education, that's what we're about. If education savings accounts are found to be constitutional, the Goldwater Institute says it’s their design to have them available to all students, not just disabled students. It would end public education as we know it in the state.

Ted Simons: Is it the camel nose under the tent kind of thing?

Clint Bolick: In the year 2011, the notion that every kid should be educated the same way is simply obsolete. Our constitution requires a public school system. We will always have that. But above and beyond that it's great to have additional choices. But Chris contradicted himself a few minutes ago. He said the constitution says if you spend government money in a private school, then it's unconstitutional. That must mean that the tens of thousands of students who Arizona is funding directly now and paying the tuition with a check from the government, they must be unconstitutional, as well.

Chris Thomas: It is significantly different and here's why. When that student is put in private placement, they are still enrolled in a public school. The public accountability is still there. The dollars are still accountable within the public school district. That is different. It's no different than having a contractor, public school districts may have contractors that are private, and some of them may be of a different nature. That is a different kind of situation. You can spend money on a contractor on a public or private placement kind of situation, and that does not offend the constitution.
Ted Simons: Aside from the difference and that sort of thing, if so many special needs kids are being placed in private schools with the agreement of the public schools where's the problem here?

Clint Bolick: Well, the problem is twofold. First of all, the School District has to agree to it. If the school district doesn't agree the parent has to sue the School District. This is enormously expensive. We're seeing here with the empowerment scholarship account, it is the parents' choice as to which direction to go. And we're going avoid costly litigation. As Chris mentioned, it's only 90% of what they otherwise would get. It is actually a net savings.

Ted Simons: Why not give the parents these options, this kind of choice, home school, private school, religious school, whatever. Why not give them that choice?

Chris Thomas: Because it offends the constitution. The object gation of our state legislature is to fund a public school system for all students, and that includes special needs students. The federal government has guaranteed those rights through the individuals with disabilities and education act. We believe disabled students, special needs students are better off within the public schools systems.

Ted Simons: The idea of public money going to private or religious schools, the Constitution does seem clear on this. Chris is mentioning oversight when it involves public schools making that particular decision. Seems pretty clear. What are we missing here?

Clint Bolick: Well, that's not what's happening here many it's like a 529 college savings account which many of the viewers are surely familiar with. It is a savings account owned by the student. There's nothing in the constitution that prohibits that. A lot of parents will use none of the money for private school tuition. They will use it for online education, for tutoring, and any money that's left over can be saved for college. In fact, the students also can enroll in community colleges while they are in the K-12 system. So there's a whole variety of uses here, and the ownership lies in the hands of the parents.

Ted Simons: The idea of aiding individuals as opposed to programs.
Chris Thomas: Well, if that were the rule, and it was a beneficiary theory, it basically wouldn't mean anything. The constitutional provision wouldn't restrict any kind of government action that aids religion. I would go back to what you said to Clint, I agree with you. The Constitution couldn't be more clear. That's what the Supreme Court said in the Kane decision. The clause means what it says, it prohibits exactly the kind of program we are talking about right now.

Clint Bolick: It's interesting, the lawyer for the School Board Association when he was arguing the Kane case in the Arizona supreme court, the justice asked him, what if a variety of choices were made available? He said that would be fine. You see the School Board association is shifting its position. We think the Supreme Court gave us a road map to help disabled kids and handle opportunities. So long as money is not going directly to private schools, and other educational options other than private schools are made available, that it's permissible.

Ted Simons: Last point, what do you make of the Kane hearing?

Chris Thomas: I don't make much of it. It's not evidence for any kind of precedence. It also loses the contempt of how that question was asked. Our lawyer, Don Peters, who represented us yesterday, made 12 that point in his briefs.

Ted Simons: We've got stop it right there, good discussion. Thanks for joining us.

Clint Bolick: Thanks for having us, Ted.