Arizona lawmaker Frank Pratt’s contributions to the lives of Arizonans will have a lasting impact on future generations. By all accounts, Rep. Pratt, who passed away on September 21, 2021, was an exceptional legislator who listened to all points of view with grace and courtesy. He was also extremely humble, often allowing others to bask in the accolades he himself had earned. It is for these traits, and for his willingness to represent his legislative district with the courage of his convictions, that the Arizona Association of Health Plans will always be indebted to this influential Arizonan.
In 2013, Arizona was faced with a monumental decision: whether to allow the Arizona Health Care Cost Containment System (AHCCCS, Arizona’s Medicaid agency), to accept federal matching funds that included Arizona expanding the number of people who could qualify for Medicaid health benefits. (For historical context, the proposal mostly restored Medicaid eligibility levels that Arizona voters passed in 2000 via Proposition 204.) As with other states, it would have been disastrous for Arizona NOT to undertake this option. Coming out of the “Great Recession,” Arizona’s budget could not maintain spending for AHCCCS at these levels. The impact would have meant hundreds of thousands of Arizonans would go without health coverage. Moreover, during this time the “hidden cost of care” was growing exponentially because of the number of uninsured individuals and families who, having no other option, were getting care from emergency departments across the state. This ultimately put tremendous pressure on health coverage rates for all Arizonans. Then-Governor Jan Brewer led the charge to combat this issue and formed a coalition of health care and business interests to help modernize Arizona’s Medicaid system and ensure coverage for eligible people.
Frank Pratt was one of the first who refused to accept the rhetoric from many in his own party, that this was “Obamacare” in disguise. He understood that, had the Arizona Legislature and the governor failed to adopt the legislation, they would have exacerbated the state’s economic problems, missing out on health care job growth, jeopardizing existing health care jobs, increasing pressure on the General Fund and increasing the costs of private insurance in Arizona. Just as important, Rep. Pratt knew that expanding AHCCCS eligibility also allowed Arizona to receive additional funding for the programs AHCCCS already had in place. His foresight over this past decade led to:
- Creation of the entrepreneurial environment within Arizona’s health care delivery system that embraces innovation, including expanded telemedicine services, payment reforms, and targeted investments, with providers partnering with Medicaid managed care organizations to shape the system to deliver high quality care to our most vulnerable citizens.
- Resolution of the decades-old lawsuit, Arnold v. Sarn, giving the mental health system the ability to innovate and expand services. For example, today Arizona provides permanent and supportive housing services to people living with a serious mental illness and ensures physical and behavioral health services are integrated to meet members’ needs.
- Expanded, enhanced Home and Community Based Services, keeping people cared for safely in their homes within their own family/community, rather than a nursing home or other institutional setting.
There are numerous examples of why Rep. Pratt’s service positively impacted the lives of so many. While he will receive praise from many throughout the state, Rep. Pratt would be more satisfied with knowing he had made a real difference for hundreds of thousands of Arizonans who may never know his name. He put political considerations aside and moved forward with the best course of action for Arizona. At the Arizona Association of Health Plans, we remember and honor his legacy.
Lorry Bottrill is CEO of Mercy Care and board chairman, Arizona Association of Health Plans.