Carl Kunasek left a large mark on Arizona as a Republican member of the Arizona State House of Representatives from 1973-1982, the Arizona Senate from 1983-1988, and the Arizona Corporation Commission from 1995-2000. Kunasek was one of the architects of the Arizona Health Care Cost Containment System, better known as AHCCCS, the state’s Medicaid program, and in the oral history below he talks about the events that led to the agency. He also tells a humorous anecdote about flying over flooded river crossings before the passage of flood plain legislation, and his memories of the impeachment trial of Gov. Evan Mecham when he was the Senate president. Kunasek’s children, Andy Kunasek and Karrin Taylor Robson, have followed in their father’s political footsteps, with Andy Kunasek serving on the Maricopa County Board of Supervisors from 1997 to 2006, and Robson running for governor in 2022 and announcing her run recently for the 2026 campaign. 

The following interview is part of the Arizona State Library Oral History Project, which started in 2006 and is printed here as an occasional feature called In Their Words. It has been edited for space and clarity. 

On what triggered the need for AHCCCS

We passed the Medicare enabling legislation, but at that time, the Legislature was controlled by the Republicans and very conservative. 

The leadership was able to get enough Republican crossover votes to pass it, although it was very close, as I recall.  But the conservatives didn’t fund it, so that then languished for 15 or 20 years – no, probably 10 or 12. Then the later years of objecting to money was very easy, because all of the scandals on the East … 49 other states had it but they were all becoming scandal ridden, money, fraud, doctors ordering stuff that they didn’t need, labs billing, hospitals billing, nobody knowing what’s going on because it was essentially a credit card operation. 

You could go into the doctor, he’d say, “OK, you need this, you need this, you need this and go get this, and this, and this, and this,” he’d send you a bill, and everybody would send Medicare a bill. Then the place is running wild. Nobody is auditing or giving any accounting. Was the lab doing all this lab work? Did the doctor actually do three physicals? Maybe he only did one. There were never any audits. And so this is where the fraud came down in these states, I always say eastern states, but it was all, it was pervasive across the country. So that made it easier for us never to fund it. Look at all the fraud, look at them wasting money. 

Late in my House tenure we had a situation developing in Arizona. The Arizona Constitution says the counties are responsible for delivering health care, and therefore they had a responsibility for paying for it. I don’t remember if the state was doing any funding for the health care but in the late 70s, there were some incidents that really brought it home as to the burden that this was placing on the counties. The most significant one was – Arizona has always had a lot of winter visitors – there was a motorcycle accident of a fellow from Ohio. Ohio had Medicare, but there was no provision in Medicare for Arizona to bill Ohio Medicare. The man was in the hospital running up hundreds of thousands of dollars in medical bills.  

Cochise or Santa Cruz County (Kunasek could not recall in which county the accident occurred) is a very small county when it comes to taxable property  and they were way upside down in debt for this one medical case … close to millions of dollars. And so it became very apparent we were going to have to do something and so I became very interested in looking at how we might approach this. And again getting back to the moral issues. I thought in learning what had happened to these other states, what we had to have was some other form of delivery that we could qualify to get some of those Medicare funds.  

On flood plain legislation

Back then, there were only two bridges you could get across the Valley on. And anytime it rained and the river was running, the old bridge in Tempe and then eventually the second bridge was I-10. 

One year we had a fella in the Legislature that was a pilot, Doug Todd, and he had an airplane he kept at Stellar Air Park, which is a private airfield in Chandler, and there were four legislators that lived on that side of the river. And so the river had been up, I don’t know how long, it just took a long time to drive back and forth. So Doug said, “Why don’t we get together? If we’ll all buy a little gas, I’ll fly us.” So that’s what we did. We all met, myself, Juanita Harrelson, Jamie Sossaman and Doug. We met down at the airplane, a 5-minute flight across the river. (Phoenix Mayor) Margaret Hance let us park at the city of Phoenix airplane pad. We kept a car there, one of us left a car there, and we get in the car and drive to the Capitol. That made a nice news story, too, when the newspapers discovered it. Oh, legislators could care less about the flooding, they fly over it, and they list all our names. 

We were fighting to get bridges. That’s what we’re trying to do. And so then I got involved in a piece of legislation that … it was to prohibit building a house or any other structure that would be occupied by human beings, by humanity from preventing that from being built in a flood plain. And you had to, the communities and the political subdivisions had to identify the 100-year flood plain. None of that had been done yet, but it was available to be done. So we passed a law that said they could not issue a building permit in the 100-year flood plain. And then to get their attention, to put some teeth into it, in the event they didn’t have this 100-year flood plain identified in such and such a time, the state would withhold their share of the sales tax. That really caught their attention. And so we, of course, then the bill really starts to get a life of its own, and it’s just ironic that God was helping – every time we scheduled a hearing it would rain and crossings would be closed. So we got that bill passed out here very easily. You can drive around and see the development where they’ll have flood retention basins. 

On the Evan Mecham impeachment trial

It was very tumultuous, and it took a lot of energy. Everybody’s energy was focused on the governor. And I believe that Governor Mecham was a good man. I agreed with a lot of what he wanted to do. We had the same, I would say we had the same moral agenda, family, Christian beliefs, and I think we had the same moral agenda on abortion, all these things, children and family most important. So I had no trouble with that part of the relationship. I did have some trouble with the relationship in his style, his management style, and his management style was what really caught up with him in the end.

If you look at the Constitution, and my reading of it, very straightforward and simple English language, when the House brings articles of impeachment, when they vote articles of impeachment, those articles then are delivered to the Senate, the Senate must conduct the trial. I didn’t want to conduct a trial. I just felt that it was unneeded. I talked to Joe Lane, who was the speaker of the House, and I said, “Joe, be sure before you bring that to a vote in the House, let’s talk. Make sure if that does come out, that it will get a good trial in the Senate.” It did get a good trial in the Senate. I would have liked to have avoided it in some way, but there was no way I could avoid it. 

And then the issue is, how are you going to run this? You’re going to recess while the trial’s going on? And I don’t know who came up with the idea that we would convene the Senate every morning, do whatever had to be done. And then we would recess to go into the court mode. So we did that, and that took two months, and then we got blamed for conducting the longest session ever conducted in the history of Arizona. Come on, two months of it was a trial, but we didn’t adjourn (Sine Die) until the trial was over. So that’s what happened.

I don’t think there’s ever been the impeachment of an executive officer in the country, in the United States, may have been, I’m not aware.

You know, I was sad. He had his own style. That was his style, a lot of members didn’t agree with it. I didn’t agree with it. That was his style, he was elected. 

I did not, I had no ability to stop the trial. There could have been motions made by a member that could have led to the stopping of the trial, but I, as far as I know, I was not aware of any mechanism that I as Senate president had to stop the trial. So we conducted the trial, and we got through with it. So that happened, and then I ran for re-election and was not re-elected from the same district. In other words, I think a lot of his supporters in Mesa thought I should have stopped the trial, and they can think that, but there was no way I could do it.