Frequently asked questions about health insurance
coverage options in Arizona
Arizona uses the federally run marketplace (exchange), which means individuals and families enroll in health plans through HealthCare.gov. The exchange is used by people who need to buy their own health insurance, including people who are self-employed, people who work for a small business that doesn’t provide health benefits, and people who have retired prior to 65 and need to purchase their own health coverage until they become eligible for Medicare.
Read our overview of the Arizona health insurance marketplace – including news updates and exchange history.
The open enrollment period for individual/family health coverage runs from November 1 through January 15. Outside of that open enrollment period, residents need a qualifying event to enroll in coverage or make a change to their plan.
Learn more in our comprehensive guides:
During the open enrollment period for 2022 coverage, 199,706 people enrolled in private plans through Arizona’s health insurance marketplace. This was a dramatic increase from the year before, when 154,504 people signed up. Arizona’s record-high exchange enrollment came in 2005, when more than 205,000 people enrolled.
Insurer participation in Arizona’s exchange has grown in recent years, with UnitedHealthcare rejoining the exchange in 2021 and Banner/Aetna CVS joining the exchange in 2022. As of 2022, there are eight insurers that offer plans in the Arizona exchange, and all of them will continue to do so in 2023.
Arizona participates in the federally facilitated marketplace (HealthCare.gov) and has expanded its Medicaid program under the ACA.
According to U.S. Census data, 17.1% of Arizona residents were uninsured in 2013, and that had dropped to 10.1% by 2017, although it crept back up to 10.6% by 2018, and to 11.3% by 2019 (nationwide there was a gradual increase in the uninsured rate under the Trump administration). While Arizona’s uninsured rate improved with Obamacare in effect, it’s still above the national average (9.2% in 2019).
As of early 2022, nearly 200,000 people were enrolled in private health plans through the Arizona exchange. All of these people have coverage for the ACA’s essential health benefits, without any lifetime or annual caps on the benefits. And most also have premium subsidies that make their monthly health insurance premiums much more affordable than they would otherwise be.
In the 2010 election, Arizona voters approved a state constitutional amendment barring any state rules or regulations that would force state residents to participate in a healthcare system. Federal law supersedes state law, so the ACA’s individual mandate still nominally applies in Arizona, although the penalty for non-compliance was repealed as of 2019.
Despite opposing the ACA in general, former Governor Jan Brewer was in favor of state-run health insurance exchange and said it was preferable to a one-size-fits-all model imposed by the federal government. To that end, Brewer established the Office of Health Insurance Exchange, and the state took numerous steps toward setting up a state-run exchange. However, with state legislators and a public majority remaining opposed. Brewer ultimately bowed to public sentiment and defaulted to the federally facilitated marketplace (HealthCare.gov).
Doug Ducey, a Republican, took over the governor’s office in January 2015 and won re-election in 2018. During his campaign, he described himself as “100 percent opposed to Obamacare.” Within months of taking office, he signed House Bill 2643 into law, effectively banning the state from creating a state-run exchange. So Arizona, like most states, continues to use HealthCare.gov.
Brewer was one of several Republican Governors who supported Medicaid expansion despite opposing the ACA in general. Ultimately, Arizona did opt to expand Medicaid under the Affordable Care Act, and Medicaid enrollment in Arizona is 82% higher in 2022 than it was in 2013. This growth is due to Medicaid expansion as well as the COVID pandemic and the resulting pause on Medicaid eligibility redeterminations.
Arizona’s Senate delegation includes Kyrsten Sinema and Mark Kelly, both Democrats who support the ACA. The state’s House of Representatives members include five Democrats and four Republicans as of 2022.
Arizona Medicaid coverage is called AHCCCS, for Arizona Health Care Cost Containment System.
Former Gov. Brewer followed a different course than most Republican governors and pushed hard for Medicaid expansion in Arizona. A bill authorizing expansion was passed with some Republican support and signed into law by Brewer in 2013.
However, the expansion has been repeatedly challenged. The Arizona legislature in February 2015 passed SB1092, which requires the state to seek an annual waiver from CMS to allow additional eligibility restrictions for Arizona’s Medicaid program – Arizona Health Care Cost Containment System (AHCCCS, which is pronounced “access”). Gov. Ducey signed the bill into law in March 2015.
In September 2016, the Obama Administration CMS approved Arizona’s waiver proposal, but eliminated the most conservative aspects of it. The new waiver ran through September 2021, but was granted a one-year extension by the Biden administration to give the state and HHS time to work through negotiations for a longer extension. The waiver rules require modest health savings account contributions from enrollees in Medicaid plans with income above the poverty level, and enrollment in an optional (rather than mandatory) job search program.
Under the Obama Administration, CMS did not allow Arizona to implement a work requirement, limit AHCCCS coverage for able-bodied adults to five years, or to charge premiums for enrollees in Arizona Medicaid plans with income below the poverty level. The state also cannot lock people out of AHCCCS for six months if they miss a health savings account contribution, or charge fees for missed health care appointments. In short, CMS denied various state bids to increase costs for enrollees.
However, the Trump administration was much more open to the sort of proposals that Arizona made in previous years, and a new Arizona Medicaid waiver received partial CMS approval in early 2019. The new waiver would have allowed the state to impose a Medicaid work requirement, although the state postponed this amid the COVID pandemic and the Biden administration ultimately rescinded the work requirement approval in 2021.
Arizona saw a 45% increase in monthly Medicaid/CHIP enrollment from 2013 to November 2016. But enrollment plateaued by 2016 (as was the case in most states), and net enrollment was up 43% as of late 2019. But by April of 2022, the total number of people covered by Medicaid/CHIP in Arizona was 82% higher than it had been in 2013. The coronavirus pandemic has driven Medicaid enrollment higher throughout the nation, including in Arizona, and highlights the importance of a health care safety net for situations where people suddenly lose their jobs, incomes, and employer-sponsored health benefits.
Learn more about Arizona’s Medicaid expansion.
Arizona changed its rules for short-term health insurance in 2019, allowing plans to follow federal rules instead of the stricter rules the state had previously imposed. So short-term plans in Arizona can have initial terms of up to 364 days, and total duration, including renewals, of up to three years.
Short-term medical plans are not considered minimum essential coverage, and the insurers’ business model tends to be quite different from that of ACA-compliant health insurers. Short-term plans do not have to provide coverage for the essential health benefits, do not have to cover pre-existing conditions, and are medically underwritten.
Get more information about short-term health insurance in Arizona.
As of early 2022, more than 1.4 million Arizonans were enrolled in Medicare coverage. Most are eligible due to age (at least 65), but 10% of the people with Medicare coverage in Arizona are under age 65 and eligible for Medicare because of a disability.
You can read more about Medicare in Arizona, including details about optional Medicare Advantage and Medicare Part D prescription plans, as well as the state’s rules for Medigap (Medicare Supplement) plans.
- Arizona Department of Insurance — Regulates and licenses health insurance companies, agents, and brokers; provides information to consumers about a wide range of insurance issue.
- Arizona Health Matters
- Arizona Association of Community Health Centers (AACHC)/Arizona Alliance for Community Health Centers — Community health centers that also serve as
- Arizona’s federally-funded Navigator organization, helping individuals and families enroll in health coverage through the exchange.
- Arizona Health Care Cost Containment System — Medicaid in Arizona. Provides health coverage to various low-income populations.
Medicare Rights Center — A nationwide service (website and call center) that provides information and assistance to medicare beneficiaries and their caregivers.
- Arizona State Health Insurance Assistance Program — A local service that can provide a variety of counseling, advice, and assistance with Medicare issues.
Here’s what’s happened recently in terms of state-level health care reform legislation in Arizona:
- Gov. Ducey signed HB2643 into law in April 2015. The legislation effectively bans the state from creating a state-run exchange.
- Also in 2015, SB1092 was signed into law, requiring the state to continue to ask CMS to approve eligibility changes for Medicaid, including a work requirement and a five-year lifetime coverage limit. The Obama Administration rejected most of the major changes that the state wanted to make, but a new waiver proposal, submitted in late 2017, gained partial approval from the Trump administration.