Lawsuit filed regarding constitutionality of Arizona Proposition 209, which addressed medical and other debt

On Nov. 8, Arizona voters approved Proposition 209 with 72% of the vote. The citizen-initiated measure is designed to reduce interest rates on debt accrued from receiving healthcare services, as well as increase the value of certain property and assets exempt from debt collection processes.

Maricopa County Superior Court Judge John Blanchard signed a temporary restraining order preventing the enforcement of provisions of Proposition 209 on Dec. 8. Plaintiffs filed a lawsuit to stop enforcement of the initiative. The plaintiffs include the Arizona Creditors Bar Association Inc. and the Protect Our Arizona PAC. An evidentiary hearing was scheduled to take place on Friday, December 16.

The lawsuit addressed the constitutionality of Proposition 209, specifically a savings clause-type provision that says that the law applies prospectively only, but that it does not apply to “right and duties that matured” before the effective date of the law. 

The lawsuit says that the language of the initiative is vague, and that there are conflicting interpretations from the Arizona judiciary, citing a Proposition 209 information sheet posted on the judiciary’s Self Service Center, which said “the proposition was unclear on when the changes to the garnishment rates would take effect, but if a debtor was being garnished on December 5, 2022, the previous rates would be continued.” The lawsuit says that due to conflicting interpretations, and lack of specific guidance regarding the savings clause provision, Proposition 209 is void under the First and Fourteenth Amendments of the U.S. Constitution, as well as Article 2, Section 4 of the Arizona Constitution. 

Rodd McLeod, spokesperson for Healthcare Rising Arizona, which led the campaign for Proposition 209, responded to the lawsuit. He said, “The people of Arizona have passed this overwhelmingly. 72% of our state voted that we should limit interest on medical debt and we should increase the protections for families that are going through that, so people don’t lose their homes because of an emergency. We think that predatory lenders should respect the will of the people.”

Healthcare Rising Arizona led the campaign in support of Proposition 209. The campaign reported $12.7 million in contributions and $12.5 million in expenditures in the past two years.

If Proposition 209 goes into effect, it would decrease the maximum annual interest rate on debt accrued from healthcare services from 10% to 3% or equal to either the weekly average one-year constant maturity treasury yield, whichever is less. It would also increase the amount of a homestead exempt from debt collection from $250,000 to $400,000. The amount of money held in an account that would be exempt from debt collection would also increase from $300 to $5,000. The amounts on other property exempt from debt collection, such as motor vehicles and household furnishings, would also be increased.

Proposition 209 was written to go into effect on December 5, 2022, but enforcement is on hold pending the lawsuit.

Republican attorneys general file petition to repeal vaccine mandate for healthcare workers

Twenty-two attorneys general filed a petition on November 17, 2022, requesting the Biden administration to repeal the vaccine mandate for healthcare workers. The Centers for Medicare and Medicaid Services (CMS) issued an interim final rule on November 5, 2021, requiring healthcare workers to receive the COVID-19 vaccine. The interim rule aimed to “protect the health and safety of residents, clients, patients, PACE participants, and staff, and reflect lessons learned to date as a result of the COVID-19 public health emergency,” according to the rule.  

The attorneys general argued that the vaccine mandate violates states’ sovereignty and will lead states to “lose frontline healthcare workers, providers, suppliers, and services, and America’s most vulnerable populations will lose access to necessary medical care,” according to the petition. The petition requests the U.S. Department of Health and Human Services and CMS to repeal the interim final rule and related guidance.  

Montana Attorney General Austin Knudsen (R), who led the coalition of state officials, released a statement arguing, “The Biden administration relied on a purported emergency to sidestep its normal requirements and rush through its flagrantly unconstitutional mandate. But evidence available at that time, and evidence that has emerged since, demonstrates that full vaccination doesn’t prevent infection or transmission. Breakthrough infections are common, and studies increasingly show heightened health risks associated with the vaccines.”

The petition was filed by attorneys general from Alabama, Alaska, Arizona, Arkansas, Florida, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Utah, Virginia, and Wyoming. 

CMS and the Department of Health and Human Services had not issued a response to the petition as of November 18, 2022. 

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Texas sues Biden administration over guidance requiring abortions in medical emergencies

Texas Attorney General Ken Paxton (R) sued the Biden administration July 14 after Department of Health and Human Services (HHS) Secretary Xavier Becerra released guidance July 11 requiring doctors to provide abortions in medical emergencies when “abortion is the stabilizing treatment necessary to resolve [the emergency] condition.” The guidance went on to say that “when a state law prohibits abortion and does not include an exception for the life and health of the pregnant person — or draws the exception more narrowly than EMTALA’s emergency medical condition definition — that state law is preempted.”

Paxton argued the guidance was too broad and that the Emergency Medical Treatment and Labor Act did not cover abortions. He said, “The Biden administration seeks to transform every emergency room in the country into a walk-in abortion clinic.”

Texas law prohibits all abortions unless a pregnancy “places the female at risk of death or poses a serious risk of substantial impairment of a major bodily function.”

The HHS guidance came after the U.S. Supreme Court decided Dobbs v. Jackson Women’s Health Organization on June 24, overturning Roe v. Wade (1973) and ruling there is no constitutional right to abortion. Dobbs returned most abortion policy decisions to the states.

For more information on Dobbs and its effect on abortion policy, click here. To learn more about state responses to federal mandates, click here.

Additional reading:

Dobbs v. Jackson Women’s Health Organization

Abortion regulations by state

Signatures submitted for three ballot initiatives in Arizona

On July 7, Arizona Secretary of State Katie Hobbs announced that three ballot initiative campaigns submitted signatures to appear on the ballot this November. If enough signatures are verified, the initiatives will join the eight legislatively referred measures currently certified for the Arizona ballot.

To qualify an initiated state statute in Arizona, campaigns must collect a number of signatures equal to 10 percent of the votes cast in the last gubernatorial election. For the 2022 general election ballot, that means 237,645 valid signatures are required.

The Arizonans for Free and Fair Elections campaign submitted 475,290 signatures for a ballot initiative that would make changes to state election and voting policies. The proposal would provide for automatic and same-day voter registration, make changes to early voting policy, and allow voters to give ballots to another person to deliver by mail, to a polling place, or to a dropbox. It would require election officials to give notice to Native American tribes regarding elections, provide that any person with a disability has a right to vote with assistance, and require that electors of a presidential election are governed by the election law in effect on January 1 of the presidential election year. It would also reduce campaign contribution limits.

“500 boxes filled in 150 days, because people believe that we should have a say what happens in our communities, and that democracy belongs to the people,” said Maria Teresa Mabry with Arizonans for Fair Elections.

Ben Petersen, a spokesman for the Republican National Committee, told The Washington Post that Arizona voters will oppose the measure. “If the initiative successfully makes the ballot, voters will reject the Democrats’ radical attempt to take over Arizona elections and change the rules in their favor,” he said.

The Voters Right to Know campaign submitted 393,490 signatures to qualify an initiative to require that anyone who makes independent expenditures of certain amounts must disclose the money’s original sources, which would be defined as the people or businesses that earned the money being spent.

“I believe that Arizonans should have the right to know who’s paying for the advertisements that they get bombarded with in every election,’’ said former Attorney General Terry Goddard (D), the co-chair of the Right to Know campaign, “Right now in Arizona there are more ‘dark money’ ads, more anonymous ads being run than in any other state on a percentage of our total advertising. And that’s just wrong.’’

This is Goddard’s third attempt at placing an initiative related to campaign contributions on the ballot. In both 2018 and 2020, he led the campaigns to place an initiative on the ballot. The 2018 initiative failed to make the ballot due to not having enough verified signatures (the campaign fell short of 2,071 signatures). In 2020, Goddard announced that the signature drive was suspended due to the coronavirus pandemic.

Healthcare Rising Arizona submitted 472,296 signatures for an initiative to limit interest rates on debt accrued from healthcare services. “Each one of us is only one major illness away from medical debt,’’ said the Rev. Dr. Bill Lyons of the Southwest Conference of the United Church of Christ, “More than two thirds of all bankruptcies are tied to medical debt from health-care costs. And 18% of Arizonans have medical bills that are past due.’’ The measure, if enacted, would limit the interest rate on medical debt to 3%, or equal to the weekly average one-year constant maturity treasury yield, whichever is less.

If the random sampling indicates that valid signatures equal to between 95 percent and 105 percent of the required number were submitted, a full check of all signatures is required. If the random sampling shows fewer signatures, the petition fails. If the random sampling shows more, the initiative is certified for the ballot.

The Arizonans for Reproductive Freedom campaign announced that it was not filing signatures for its initiative to provide that “Every individual has a fundamental right to reproductive freedom.” As a constitutional amendment, the initiative required 356,467 valid signatures. The campaign reported collecting more than 175,000 signatures during its 61-day signature drive.

From 1985 to 2020, 62 initiatives were placed on the ballot – 33 (53%) of them were approved by voters, while 29 (46%) of them were defeated.

Additional reading:

Arizona Campaign Finance Sources Disclosure Initiative (2022)

Arizona Interest Rate Limit on Debt from Healthcare Services and Collection Exempt Property and Earnings Increase Initiative (2022)

Arizona Election and Voting Policies Initiative (2022)

Oregon Drug Decriminalization and Addiction Treatment Initiative will appear on ballots in November

On June 30, 2020, the Oregon Secretary of State completed the signature verification process for the Oregon Drug Decriminalization and Addiction Treatment Initiative and officially certified the initiated state statute for the ballot. Yes on IP 44 is sponsoring the initiative and submitted 156,009 raw signatures. The state verified that 116,622 signatures or 74.75% of signatures submitted were valid.

In Oregon, the number of signatures required to qualify an initiated state statute for the ballot is equal to 6 percent of the votes cast for governor in the most recent gubernatorial election. For 2020 initiatives, the required number of signatures was 112,020. Oregon is one of six states that use random sampling to verify signatures.

The Oregon Drug Decriminalization and Addiction Treatment Initiative would reclassify certain drug offenses. Possession of a controlled substance in Schedule I-IV would be reclassified from a Class A misdemeanor to a Class E violation. The initiative would also establish a drug addiction treatment and recovery program funded by the state’s marijuana tax revenue.

The measure would give authority to the Director of the Oregon Health Authority to establish the Oversight and Accountability Council, which would give grants to the government or community-run organizations to create Addiction Recovery Centers. The centers would offer immediate assistance at any hour of the day, health assessments, intervention plans, peer support, and mobile or virtual outreach to clients. The measure would also establish the Drug Treatment and Recovery Services Fund that would receive 20 percent of the funds in the Oregon Marijuana Account every quarter.

In the campaign’s press release announcing the certification, Janie Gullickson, chief petitioner and the executive director of the Mental Health and Addiction Association of Oregon, said, “This initiative will save lives, and we urgently need it right now because the pandemic has exacerbated Oregon’s addiction epidemic.”

Yes on IP 44 previously announced on May 4 that they would be coordinating their campaign efforts to gather signatures with the Yes on IP 34 campaign that is sponsoring the Oregon Psilocybin Program Initiative to ensure the campaigns reached their signature goals. As of June 23, Yes on IP 34 had submitted 106,908 valid signatures of the 112,020 needed. The deadline to submit signatures was July 2.

Citizens of Oregon have the powers of initiated state statute, initiated constitutional amendment, and veto referendum. The Oregon State Legislature may also place measures on the ballot as legislatively referred constitutional amendments or legislatively referred state statutes with a majority vote of each chamber.

The Drug Decriminalization and Addiction Treatment Initiative was the first citizen initiative to qualify for the 2020 ballot. The legislature referred two measures to the 2020 ballot.

Between 1995 and 2018, about 45% (74 of 164) of the total number of measures that appeared on statewide ballots during even-numbered years were approved, and about 55% (90 of 164) were defeated.

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