Ciscomani & Mendoza spar over healthcare policies in Southern Az congressional race

The future of insurance, hospitals and healthcare is a major issues in the race for Southern Arizona’s Congressional District 6.

The contest between Republican U.S. Rep. Juan Ciscomani and Democratic challenger JoAnna Mendoza is one of the toss-ups that could decide the control of the U.S. House of Representatives. Democrats need to flip a total of three seats across the nation to win back control of the chamber.

Ciscomani, who is seeking a third term in the Nov. 3 election, has said his support of the One Big Beautiful Bill, the signature budget plan that was signed into law by President Donald Trump on July 4, 2025, would protect Medicaid by rooting out fraud and abuse.

“We want to make sure that people that need this service, they have it,” Ciscomani said. “We need to expand and strengthen the safety net of our system so that it can take care of the people that are in the most need.”

Mendoza, a former Marine who previously ran unsuccessfully for the Arizona Legislature in 2020, says Ciscomani cast the deciding vote for a budget plan that creates bureaucratic red tape designed to push hundreds of thousands of low-income Arizonans off the Arizona Health Care Cost Containment System (aka AHCCCS, the state’s version of Medicaid). That, in turn, will mean fewer dollars for hospitals and clinics, particularly those in rural areas throughout Congressional District 6, at a time when they are already operating on slim margins.

“We need to revert the cuts that have been made to AHCCCS and Medicaid,” Mendoza said in last week’s debate.

Mendoza sidestepped questions on how she would restore the funding if elected to Congress.

Healthcare administrators sound alarm

A Congressional Budget Office analysis of the One Big Beautiful Bill estimated that, over the next decade, the legislation would cut projected spending on Medicaid and the Children’s Health Insurance Program by more than a trillion dollars, leading to an additional 11.8 million Americans going without health insurance.

Among other provisions, the GOP budget plan requires Medicaid recipients to reapply for their benefits at least twice a year. Enrollees between 19 and 64 must work at least 80 hours per month or perform community service or attend classes.

Daniel Derksen, the director of the UA Center for Rural Health, said he was concerned about provisions in the GOP budget plan that are “basically implementing things that make it harder for people to stay enrolled in Medicaid.”

Or, as Tucson Medical Center President Jennifer Mendrzycki said at an October 2025 gathering sponsored by the Chamber of Southern Arizona: “I don’t know if any of you have had any experience with signing family members up for Medicare or perhaps even for anything related to the government. Not to disparage the government, but there are some challenges with getting some of that work done.”

Under the current law, anyone earning less than 138 percent of the federal poverty line is eligible for AHCCCS, with the federal government providing between 64 to 90 percent of the funding and the state kicking in the remainder.

The AHCCCS program provides health care coverage to “low-income residents, including children, pregnant women, elderly individuals and people with disabilities,” said Julia Strange, Tucson Medical Center’s vice president of external affairs.

The state contracts with private insurers, which then provide insurance plans to AHCCCS enrollees, Strange said at a 2025 town hall with Sen. Mark Kelly. More than 2 million Arizonans are on AHCCCS, including about 72,000 people who are elderly or who have significant disabilities, Strange said. She added that about 40 percent of the enrollees are children.

Strange said providing health insurance to AHCCCS enrollees means they can address health issues before their conditions spiral out of control. For example, someone with insurance can get “an early diagnosis of colon cancer rather than getting a late-stage cancer diagnosis in the emergency department with no means or access to even what is now end-of-life care,” she said.

Strange warned that more uninsured patients would lead to overcrowded emergency rooms.

“No matter what your insurance is, you’re going to be affected by this bill,” Strange warned. “We’ll go back to where we were in 2006 when it was 18-hour waits.”

Financial hit to hospitals, clinics

Overcrowded ERs and bad health outcomes aside, there’s also a financial hit to hospitals, which are required by federal law to provide emergency care to those without health insurance. Treating uninsured patients, Strange said, will result in more “bad debt and charity care hospitals.”

The Arizona Hospital and Healthcare Association predicted last year that the legislation would cost hospitals $6 billion over the next seven years and more than half of the state’s hospitals could end up operating in the red.

“This bill goes too far,” said Ann-Marie Alameddin, president and CEO of AzHHA. “It removes Arizona’s flexibility, forces new fiscal burdens on our state and risks dismantling a system voters and lawmakers have repeatedly endorsed.”

Following the passage of the GOP budget plan, El Rio Community Health President and CEO Clinton Kuntz said the organization was “deeply disappointed.”

Kuntz said the legislation “will reshape healthcare for everyone in this country, not just those on AHCCCS/Medicaid. You cannot make a trillion dollars of cuts and push 12 million people to be newly uninsured without having profound consequences for the entire healthcare system.”

Strange said AI advances might bring some efficiencies and healthcare executives were working to find solutions.

“I think we’ll address some of these issues,” she said. “But services are going to close, and hospitals will close. People focus on rural, but the urban hospitals are just as vulnerable.”

A study by Third Way estimated that 10 hospitals in and around Congressional District 6 could close as a result of the budget plan.

Derksen, who studies rural health care, called the cuts “a huge concern. I don’t care if you practice in a rural area or urban area, hospital or clinic, no one can absorb a loss of 10 to 15 percent of those who have a payment source from their thing and still operate the types of services we need, like maternal healthcare.”

Ciscomani himself warned that the legislation would be damaging to the health care sector in letters opposing healthcare cuts before he voted for the final version of the bill.

He co-signed an April 17 letter to House leadership with 12 other Republican lawmakers, who wrote: “Cuts to Medicaid also threaten the viability of hospitals, nursing homes, and safety-net providers nationwide. Many hospitals — particularly in rural and underserved areas — rely heavily on Medicaid funding, with some receiving over half their revenue from the program alone. Providers in these areas are especially at risk of closure, with many unable to recover. When hospitals close, it affects all constituents, regardless of healthcare coverage.”

He said during last week’s debate with Mendoza that he withheld his support until GOP leaders removed a provision from the legislation that would have reduced federal matching funds for the program.

But the legislation does, over time, cap a key element that provides the state’s share of matching funds: provider taxes, which are paid by hospitals and other healthcare providers. Arizona’s current tax rate is 6 percent (which was forecast to bring in roughly $1.5 billion in fiscal year 2026), but it must reduce that each year until it reaches a maximum of 3.5 percent by 2032. As a result, the state will have to find hundreds of millions of dollars each year from another source or forgo federal matching funds.

Ciscomani noted last year that the cap on the provider tax would be harmful to hospitals. In a letter he co-signed with 15 other House Republicans in June 2025, he and his colleagues said the legislation “undermines the balanced approach taken to craft the Medicaid provisions in H.R. 1—particularly regarding provider taxes and state directed payments.”

The GOP lawmakers said they were “concerned about rushed implementation timelines, penalties for expansion states, changes to the community engagement requirements for adults with dependents, and cuts to emergency Medicaid funding. These changes would place additional burdens on hospitals already stretched thin by legal and moral obligations to provide care.”

While they said they “cannot support a final bill that threatens access to coverage or jeopardizes the stability of our hospitals and providers,” Ciscomani voted in favor of the Senate version of the One Big Beautiful Bill days later, on July 3, 2025.

Rural health funding

Ciscomani said that rural hospitals may take a hit when they lose AHCCCS patients, but the One Big Beautiful Bill balanced the cuts with the Rural Health Transformation Program, a new $50 billion initiative to support rural hospitals across the nation.

Derksen also praised the program, which is designed to assist rural health clinics with technological improvements, including telemedicine.

He said about half the state’s funding for the Rural Health Transformation Program would be in rural health workforce development, “which is very good, but there’s a significant chunk for things that I think are really going to transform the way we teach, the way we learn, and all that. That’s digital transformation, artificial intelligence.”

While he said the overall program would spend $50 billion over the next five years across the nation, Ciscomani himself expressed disappointment that Arizona received so little of the funding compared to other states. Arizona received $167 million for the first year of the program.

That was the sixth-lowest per-capita distribution of the funds among the 50 states.

El Rio CEO Clinton Kuntz, who told Tucson Sentinel in January that the “allocation is lower than expected, and that raises more concerns for providers already operating on very thin margins. An important point to remember is that this fund is intended to support transformation, technology, and innovation, not replace the Medicaid dollars that rural areas and providers stand to lose.”

Ciscomani told Tucson Sentinel in January that Arizona’s allocation of the funding “falls short of my expectations.”

“The working families in rural Arizona deserve to get their fair share,” Ciscomani said. “This can only be achieved by working in close partnership with the Trump administration and Gov. Hobbs’ office – a bipartisan effort I will continue to pursue for AZ06. This fight is far from over.”

In the debate last week, Ciscomani praised the funding he previously called insufficient.

“This bill that my opponent criticizes also brought in $167 million specifically for rural healthcare,” Ciscomani said.

Mendoza said the $167 million didn’t make up for what rural hospitals are going to lose.

“It’s like bringing a glass of water to a fire that you started, Mr. Ciscomani,” she said.