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Connection Newsletter
By AzHHA Communications ● Oct. 23, 2025
Smart Brevity® count: 5 mins...1274 words
This week, read about:
- The GOP debating the ACA subsidy extension.
- Updates on hospital assessments and HEALTHII payments.
- Applications for the Healthcare Leadership Academy.
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GOP debates ACA subsidy extension as increasing premiums shock consumers
It’s day 23 of the federal government shutdown—the longest full government shutdown on record—with no clear path forward in sight.
- With their Nov. 21 continuing resolution (CR) now widely viewed as insufficient, GOP leaders are debating a much longer CR, potentially as long as a year, which would be unpopular with many in the Republican caucus.
- Democrats continue to maintain that they won’t vote to reopen unless an extension of the Affordable Care Act’s (ACA) enhanced premium tax credits is included in the CR, while GOP leaders insist on reopening first and then holding a separate vote on the ACA subsidies.
To make the ACA subsidy extension more palatable to conservatives, GOP leadership is considering pairing it with Pharmacy Benefit Manager reforms, Health Savings Account expansions and/or the “CHOICE” proposal that would let employers provide tax-free dollars for workers to purchase ACA-compliant individual coverage.
- The GOP is also considering altering the structure of the tax credits, such as imposing an eligibility income cap and mandating new minimum out-of-pocket premiums.
- A letter from 13 House Republicans to Speaker Mike Johnson warns that “[a]llowing these tax credits to lapse without a clear path forward would risk real harm to those we represent.”
Why it matters: This growing pressure to address the issue arises as open enrollment threatens confusion and rising costs for households.
- Insurers have already released 2026 rates assuming current law. If the credits are extended mid-open enrollment, insurers may need to make material changes to their rates and materials, creating consumer confusion.
- Some experts believe that soon there won’t be enough operational time for systems to implement any major changes for the year.
- The Kaiser Family Foundation estimates that, without an extension, subsidized enrollees’ average premium payments would more than double – an increase of $1,016 more per year on average.
- Consumers can calculate household-level impacts with KFF’s premium increase calculator.
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Hospital assessments and HEALTHII payment updates
Arizona hospitals are expected to receive $2.9 billion in net HEALTHII supplemental payments in Federal Fiscal Year (FFY) 2026 (Oct. 1, 2025–Sept. 30, 2026).
Key quality deadline: HEALTHII quality metrics must be submitted by Friday, Nov. 21, 2025.
- These metrics determine 15% of total HEALTHII payments and missing the deadline could result in significant financial losses for a hospital.
Approval status: The Arizona Health Care Cost Containment System (AHCCCS) is still awaiting approval from the Centers for Medicare and Medicaid Services (CMS) for both the hospital assessments and HEALTHII payments.
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What’s next: In prior years, CMS approval typically came between mid-October and late November. So far, CMS has not flagged any major issues, but the ongoing government shutdown may contribute to approval delays.
Assessment due dates: The next Hospital Assessment Fund (HAF) payment is due Saturday, Nov. 15, 2025 or 30 days after AHCCCS notification—whichever is later.
- AHCCCS will not issue invoices until CMS approval is received. Once approved, AHCCCS will provide the 30-day notification for the HAF assessment, notify hospitals of the due date for the Health Care Investment Fund payment and share estimated dates for HEALTHII payments.
Reconciliation update: AHCCCS has initiated the FFY 2024 HEALTHII reconciliation.
- Hospitals should have received their final reconciliation earlier this month. These reconciliations are expected to align with the March 2026 HEALTHII payments.
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Apply now: Healthcare Leadership Academy
Applications are currently being accepted for the 2026 cohort of the Healthcare Leadership Academy (HLA).
- The AzHHA Foundation partners with Creighton University’s College of Professional and Continuing Education to provide healthcare leadership and management education to rising leaders within AzHHA member hospitals.
- Nine months of learning begins in March 2026 and culminates in November 2026 which includes three in-person and six virtual sessions.
- The HLA is geared toward mid-level managers and early-stage executives to prepare them for C-suite positions.
- This is third cohort of the HLA. Learn more about the program here.
What’s next: To apply, submit your resume, letter of support and statement of purpose in one PDF to [email protected] by 5 p.m. on Friday, Nov. 28, 2025.
If you have any questions, please contact Laura Dickscheid, vice president of member services and 2024 HLA participant, at [email protected].
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Outbreak readiness at risk from staffing cuts and the ongoing shutdown
A full federal shutdown of unprecedented length paired with mass layoffs at public health agencies has thinned outbreak response capacity and risks eroding the nation’s emergency response infrastructure.
- The Centers for Disease Control and Prevention’s (CDC) workforce has endured sweeping reduction-in-force actions; implementation is currently paused under a court order, leaving critical programs short-staffed and in limbo.
- The shutdown prevented many CDC scientists from attending IDWeek—the nation’s flagship infectious diseases meeting in Atlanta—curtailing federal engagement with clinicians and researchers at a time of renewed measles and pertussis activity.
Government watchdogs and researchers are sounding the alarm. The Infectious Diseases Society of America warned that unprecedented Department of Health and Human Services firings could “compromise the health of all Americans.”
- As U.S. staffing turbulence and the ongoing federal shutdown appear to be widening preparedness gaps, the Global Preparedness Monitoring Board has urged stronger national readiness in monitoring, countermeasures access and coordination.
Meanwhile, the American Hospital Association is pressing Congress to bolster medical supply chain resilience and has asked the Trump Administration to establish a tariff-exception process for essential personal protective equipment, medical devices and medications, especially items in shortage.
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Member spotlight: Canyon Vista Medical Center
Canyon Vista Medical Center and the Legacy Foundation of Southeast Arizona will host a Veterans Wall Ceremony.
- The ceremony will recognize the 12 Veterans Wall honorees for 2025-26.
- The event will take place at 4:30 p.m. on Thursday, Nov. 6 at Canyon Vista Medical Center.
Why it matters: The Veterans Wall honors those who have worn the uniform of the U.S. Armed Forces and significantly contributed to their communities.
- Each honoree exemplifies the spirit of selfless service, making Cochise County a stronger and more connected place to live.
If you’d like to attend the event, please RSVP to Natoyah Swift at 520-263-3299 or [email protected] by Saturday, Nov. 1, 2025.
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Oct. 28-29 - Medical Leadership in Disaster Preparedness and Response Conference
This free, virtual event will bring together individuals who have a medical direction role during disasters to discuss the spectrum of medical leadership responsibilities and some of the specific challenges of the role. This conference is co-hosted by the U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response, Technical Resources, Assistance Center and Information Exchange, and the American College of Emergency Physicians. Register now.
Friday, Nov. 7 - Peer support training for health professionals
The Wellbeing Collaborative is offering a powerful in-person training for healthcare professionals interested in building or strengthening peer support programs in their organizations. This interactive training includes real-world strategies, hands-on practice and expert guidance to promote connection, resilience and psychological safety across teams. Learn more and register.
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