Where Julie Stands on
Healthcare Access + Behavioral Health
Why This is Personal
“I didn’t come to this issue from a briefing paper. I ran a behavioral healthcare organization serving Arizonans in addiction recovery, most of them on Medicaid. I’ve seen how poorly designed healthcare policy affects patients, providers, and businesses. Lagging Medicaid reimbursement rates combined with cuts to Medicaid mean healthcare providers struggle and patients lose access to care.
I have the experience to be part of solutions that improve the well-being of Arizonans.”
Protect AHCCCS from cuts
More than two million Arizonans depend on Arizona's Medicaid program, AHCCCS. Cutting healthcare coverage for some of our most vulnerable populations doesn’t reduce costs. It shifts them to emergency rooms and raises premiums for everyone with private or commercial insurance. Cuts to this program inevitably lead to increases in your healthcare and insurance costs.
ensure behavioral health Provider sustainability
Behavioral health care providers are struggling in Arizona today. Medicaid reimbursement rates must keep pace with the real cost of delivering care. Administrative requirements should be streamlined to improve efficiency without compromising the oversight necessary to prevent fraud, waste, and abuse. Untreated mental illness devastates families, reduces workforce productivity, and burdens every other system we fund. Julie will fight to protect and expand Arizona's behavioral health infrastructure because it is the fiscally responsible thing to do, not just the compassionate one.
Protect rural hospitals
Arizona’s rural hospitals run on thin margins. When one closes, entire communities can find themselves hours from emergency care, compromising healthcare outcomes. The Arizona State House must use every tool available to keep these rural hospitals open, because it’s truly a life-or-death situation.
Expand preventive and primary care
Preventive care costs far less than emergency care. Shifting Arizona's healthcare expenditure to expanded primary care access, mental health services, and preventive programs is a strategy to increase well-being for all Arizonans and reduce more expensive emergency healthcare costs.
Frequently Asked Questions
Are behavioral healthcare providers struggling to provide care in Arizona?
According to the federal Health Resources and Services Administration (HRSA), over 200 Arizona communities are designated as Health Professional Shortage Areas, meaning they do not have enough healthcare providers to meet current demand; additionally, over 90 of these communities lack sufficient mental health professionals. HRSA's shortage-area data identify significant gaps in health access across both urban and rural parts of the state. Behavioral health providers report ongoing challenges recruiting and retaining qualified clinicians, particularly in rural areas, while increasing operating costs and workforce shortages continue to affect service capacity.
Sources: [1] HRSA Data Warehouse; [2] HRSA Health Professional Shortage Area Locator.
What would Medicaid cuts mean for Arizona patients and families?
Research published in the peer-reviewed journal Health Affairs found that hospitals in states that expanded Medicaid experienced substantial reductions in uncompensated care costs, while hospitals in non-expansion states saw little change. The study estimated that uncompensated care costs fell from 4.1% to 3.1% of operating costs at hospitals in Medicaid expansion states. Researchers concluded that broader insurance coverage reduced the amount of care hospitals provided without payment. As a result, cutting Medicaid coverage could increase uncompensated care burdens for hospitals and healthcare providers, particularly those serving large numbers of low-income patients. Therefore, cuts to Arizona’s Medicaid program, AHCCCS, may shift costs to hospitals in the form of uncompensated care burdens.
What is Julie Gable’s position on AHCCCS and Medicaid cuts?
According to a data report prepared for AHCCCS by Health Management Associates, nearly 2 million Arizonans receive health coverage through AHCCCS, including more than 700,000 children. Julie Gable opposes reductions to AHCCCS funding and eligibility. Her position is based in part on research which shows that Medicaid coverage reduces uncompensated care costs for healthcare providers, as well as an Arizona Chamber Foundation report which found that for every $1 billion cut in Medicaid spending, Arizona may lose more than 36,000 jobs across multiple sectors, and $3.7 billion in total economic activity.
Sources: [1] Health Management Associates, AHCCCS Data to Inform Potential Federal Medicaid Changes; [2] Dranove et al., Health Affairs (2016); [3] Arizona Chamber Foundation, New Economic Analysis Warns of Significant Job Losses, Higher Health Care Costs if Federal Medicaid Cuts Move Forward.
Why are rural hospitals closing across Arizona?
Rural hospitals nationwide face significant financial pressures as they serve smaller populations with many of the same fixed costs as urban hospitals. According to a study by The Commonwealth Fund, since 2005, nearly 200 rural hospitals across the United States have completely or partially closed, and more than 400 additional rural hospitals — over 20% of all rural hospitals — are considered at risk of closure.
The University of Arizona found in 2025 that, amid proposed Medicaid funding reductions, at least five rural Arizona hospitals were at risk of closure. The surrounding cities totaled more than 50,000 people. Reductions in Medicaid funding could increase financial pressures on rural hospitals and increase the risk of additional closures.
Sources: [1] The Commonwealth Fund, Why Rural Hospitals Are Facing a Funding Crisis — and How It Could Get Worse; [2] American Hospital Association, Rural Hospital Closures Threaten Patient Access to Care; [3] University of Arizona, Reverse Robin Hood: Medicaid Cuts Threaten Rural Arizona Hospitals To Fund Top 1% Tax Breaks.
