ArizonaHB 4160Fifty-seventh Legislature - Second Regular SessionHouseWALLET

health care; 2026-2027

Sponsored By: Sponsor information unavailable

Signed by Governor

2026-2027ahcccs (see also: arizona health care cost containment system)altcs (see also: arizona long-term care system)applicabilityarizona health care cost containment system (ahcccs)arizona long-term care system (altcs)arizona rural health transformation fundcountiescounty acute care contributionsdementia services programhealth carehealth insurance trust fund oversight boardlegislative intentmental health medication utilizationopioid settlement funds agreementpresumptive eligibilitypublic health and safety - title 36public officers and employees - title 38rulemaking exemption

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Bill Overview

Analyzed Economic Effects

11 provisions identified: 8 benefits, 1 costs, 2 mixed.

New premium goals for state workers

A new board approves state employee health plans, premiums, copays, and deductibles. It must aim for employers to pay 85% of medical premiums and employees to pay 15% by plan year 2035. The board also sets goals for claims reserves and retiree cost-sharing. Starting in plan year 2028, it must approve covered contracts over $3 million. The board sets rules for sharing anonymized, combined plan data with participating employers.

Traditional healing covered for some members

AHCCCS and its contractors provide pilot coverage for traditional healing services during fiscal years 2026–2027 through 2028–2029. The member must qualify for Indian Health Service or tribal facility services. The care must be delivered by or through an urban Indian organization, and the pilot requires federal approval.

Tighter Medicaid checks and hospital access

For reviews scheduled on or after January 1, 2027, AHCCCS must check records for wages, work, unemployment, lottery and gambling winnings, deaths, and out-of-state enrollment. Where federal law allows, it must verify residency rather than accept self-attestation. AHCCCS must ask federal officials by April 1, 2027, to limit hospital presumptive eligibility to children and pregnant women; that limit starts only if approved. Hospitals must notify the state within five working days, help applicants apply, and give written coverage notices. These temporary rules end June 30, 2027.

Counties fund long-term and acute care

For fiscal year 2026–2027, counties must help pay for long-term care and acute care. Long-term care contributions range from $138,200 for Greenlee County to $298.9 million for Maricopa County. Acute care contributions range from $190,700 for Greenlee County to $14.95 million for Pima County; counties pay one-twelfth each month by the fifth day. The Treasurer can withhold state payments, except highway revenue, for unpaid amounts. AHCCCS must also transfer counties any amount needed to meet a federal funding rule by December 31, 2027. Certain county health-program administrative costs do not count toward county spending limits.

Arizona coordinates dementia services

The Arizona Department of Health Services coordinates dementia-related work and seeks related funding. It must update the state plan and hold stakeholder sessions at least once each calendar year. The updated plan must be submitted and published by June 30, 2027. The law does not guarantee an individual service or payment.

Counties get competency spending-limit relief

County contributions for competency restoration do not count toward county expenditure limits. This changes how counties count those costs, but does not create a household payment or benefit.

Opioid funds reduce local penalties

For fiscal year 2026–2027, a county, city, or town can have its spending-limit penalty reduced when One Arizona opioid settlement money caused it to exceed its limit. The reduction equals the amount spent from those funds, but cannot reduce the penalty below zero.

Federal money supports rural health work

Arizona creates a fund for money received through the federal Rural Health Transformation Program. The money is continuously available to AHCCCS for the program. Before the state spends it, officials must hold three public meetings in each of northern, central, and southern Arizona’s largest metropolitan areas and report the spending plan to lawmakers.

Medicaid plans keep temporary funding rules

From October 1, 2026, through September 30, 2027, AHCCCS may continue risk-contingency rate setting for managed-care organizations. It may also continue their administrative funding levels from the 2010–2011 contract year. The law does not set a household payment or change who qualifies for care.

More funding for safety-net hospitals

For fiscal year 2026–2027, the Arizona State Hospital receives $28.47 million, and qualifying private hospitals receive $884,800. Private hospitals must meet federal rules or be in Yuma County with at least 300 beds. Later payments go first to qualifying hospitals in counties with fewer than 400,000 people, then to counties with 400,000 to under 900,000, and then to larger counties. The State Hospital must file its certified expense form by March 31, 2027.

Local opioid funds cannot buy smoking supplies

Cities, towns, and counties cannot use money from the final One Arizona opioid settlement distribution to provide safer smoking equipment. They also cannot give that money to a nonprofit for this purpose. The restriction covers sterile, durable equipment intended to reduce health risks from inhaling drugs.

Sponsors & Cosponsors

Cosponsors

David Livingston
Republican • House
Julie Willoughby
Republican • House
Michael Carbone
Republican • House
Neal Carter
Republican • House
Steve Montenegro
Republican • House

Roll Call Votes

All Roll Calls

Yes: 47 • No: 5

Senate vote • 6/11/2026

Third Reading: Passed

Yes: 24 • No: 4

House vote • 6/10/2026

Appropriations: DP

Yes: 15 • No: 1 • Other: 2