Future of ACA and Health Coverage Hang in the Balance in Upcoming Presidential Race

In southern Arizona, Maria Losoya stands out not as a doctor, but as a vital health care navigator. Despite lacking medical qualifications, she plays a crucial role in assisting community members in Santa Cruz County, where nearly one in three residents lacked health insurance in 2022, according to the National Institutes of Health.

Losoya’s expertise in the health insurance marketplace—offered in both English and Spanish—has made her a go-to resource for many. Residents often reach out to her during difficult times, seeking guidance on securing coverage for essential treatments like emergency care or chemotherapy.

Her work seeks to dismantle barriers hindering access to health care, such as language challenges and misinformation about coverage. “A lot of people were dying,” Losoya said, highlighting the urgency of her mission.

As a navigator, she assists individuals in overcoming the complexities of health insurance enrollment, a role established by the Affordable Care Act (ACA) to address inequities faced by marginalized communities. In Arizona, these navigators extend their services to diverse populations, including Native Americans with limited internet access and immigrants who speak little English.

Since navigators began their work in 2013, the uninsured rate in Arizona has dropped from over one in six to approximately one in ten. These services are provided at no cost to the community; however, navigators rely heavily on federal funding, which has fluctuated based on political leadership.

The stability of this funding has become a pressing concern as the upcoming presidential election looms. Navigators worry about how the election outcome could affect the communities they serve. “We’re able to serve less people when the funding goes down,” stated Layal Rabat from the Phoenix-based nonprofit Asian Pacific Community in Action (APCA). Rabat emphasizes that funding cuts directly impact access to life-saving treatments.

Currently, navigators are benefiting from a five-year, $500 million investment announced by the Biden-Harris administration. So far, $100 million has been allocated nationwide, with Arizona receiving $3.5 million in August. However, uncertainty remains regarding future allocations, especially if Donald Trump emerges victorious in the election. KFF Vice President Kaye Pestaina warns that Trump could roll back the remaining $400 million promised to navigators.

During his presidency, Trump reduced navigator funding significantly, a cut that coincided with a decline in health insurance enrollment. This trend particularly affects vulnerable communities, as noted by Daniel Derksen, director of the Arizona Center for Rural Health.

Funding limitations have led to staffing reductions at organizations like APCA, where the number of navigators has fallen from 17 to just five. Natalie Huynh, one of the remaining navigators, assists the increasing number of Asian American, Native Hawaiian, and Pacific Islander residents in accessing health care. Having navigated the complexities of the American health system herself, she now uses her language skills to help others.

As the political rhetoric around the ACA heats up, Democratic nominee Kamala Harris has positioned herself as a steadfast supporter of the Act, emphasizing the need for its expansion and improvement. In contrast, Trump has criticized the ACA’s costs while making vague promises about strengthening it without clear commitments to its funding.

While Arizona navigators recognize the need for enhancements to the ACA, they are deeply concerned about the idea of a repeal. Such a move could jeopardize their roles and the crucial services they provide. “The work is still going to be there,” Liza Merrill of APCA said. Her sentiment underscores a commitment that transcends titles or funding: many who work in this field do so out of a deep-rooted desire to support their communities.