Local advocacy groups in several states that have passed progressive ballot measures in recent years — such as Arkansas, Missouri and Oklahoma — have expressed interest in launching their own health care debt campaigns, according to the Fairness Project, which supports passing progressive policies through the referendum process. .

“This model of protecting more working families from the impact of even a small amount of debt is going to be a big part of what we’re going to see at the polls in the next cycle or two,” said Kelly Hall, executive director of the Fairness Project.

The November measure comes as state health care advocates grapple with how to help residents with rising health care costs now that Congress appears unable to pass any meaningful reforms to address the problem. Nearly 1 in 10 US adults have health care debt, including 3 million who owe more than $10,000. analysis of the Kaiser Family Foundation.

Democratic state lawmakers have passed legislation in recent years to address health care costs through public health insurance options, health care spending commissions and medical debt reform. Last year, the states of California, Colorado, Illinois, Maryland, Nevada and New Mexico passed bills dealing with medical debt.

In April, the Biden administration sought to address medical debt by ordering federal agencies to eliminate such debt as a factor in accessing federal resources, streamlining debt relief for veterans and targeting, through the Consumer Financial Protection Bureau, unscrupulous debt collectors trying to collect on debt that is already exists. received money or impersonated law enforcement agencies.

An estimated 875,000 Arizonans — about 12 percent of the state — have medical bills in collections, with an average debt of $719. an Urban Institute analysis.

If the measure passes, lenders would not be allowed to charge more than 3 percent interest on medical debt, up from 10 percent. It would also increase the value of a debtor’s creditor-protected home from $250,000 to $400,000 and reduce the percentage of the debtor’s weekly disposable income that is subject to debt collection from 25 percent to 10 percent.

“We simply do not believe that anyone should lose their home or car, their means of getting to work and their livelihood because of health care bills they cannot pay,” said Rod McLeod, a spokesman for Healthcare Rising Arizona, what a vote of support. “This measure is an attempt to create respite for families struggling with debt.”

Opponents — who mostly represent lenders — say the proposal is too broad because the asset protection provisions would apply to all forms of debt, not just medical debt, which they say would destroy the state’s credit market. The Arizona Chamber of Commerce, the Arizona Bankers Association and the Arizona Free Enterprise Club are among the organizations opposing the measure.

“It’s marketed as a medical debt initiative, but it still affects all remedies,” said Amber Russo, a spokeswoman for Protect Our Arizona, which opposes the measure. “My concern with this question is that it’s a bridge too far.”

Protect Our Arizona also took aim at the fact that the Arizona measure is funded by SEIU-UHW, the California health workers union that founded the Fairness Project in 2015 to promote progressive ballot measures across the country and, most recently, supported Healthcare Rising Arizona to organize health workers and Arizona patients around health care reform.

SEIU-UHW and Healthcare Rising Arizona have contributed about $8 million in cash and in-kind contributions to Arizonans Fed Up with Rising Healthcare, the primary PAC supporting the measure, as of the end of September. Opponents used the numbers to argue that a deep-pocketed California union is “buying the legislation” — mirroring complaints that conservatives in particular across the country are making about other progressive ballot measures.

“It gives me such a raw feeling because it looks like buying legislation,” Russo said.

The union did not respond to multiple requests for comment, but supporters of the measure in the state, including Kelly Griffith, CEO of the Center for Economic Integrity in Tucson, said the union made it possible for the first time for debt reform advocates to show up at the ballot box, and not react like the group did when it came out in defense of payday loans in 2008.

“Prop. 209 is really an offensive endeavor that our small organization would not have the financial resources to do on its own, Griffith said.

Other supporters include the Arizona Public Health Association, the AIDS Foundation of Southern Arizona and several local labor unions.

Protect Our Arizona, on the other hand, has raised approximately $530,000, most of it from the Arizona Creditors Attorneys Association. Opponents of field voting in Arizona say big banks that could have helped their cause haven’t shown much interest in the measure.

“Are there big banks in the financial industry? Of course. But I think you have a lot more risk tolerance at the top level, that they’re going to wait and see what happens,” Russo said. “Maybe by the time it hits Colorado or Michigan or Illinois, they’ll be like, ‘Oh, look at this trend.'”

The ballot has not drawn as much attention as Arizona’s high-profile races for governor and senator, where polls show both races remain unwinnable. But with national Democrats struggling to talk about inflation and the economy, the political landscape could provide additional momentum for the Arizona election as voters remain very cost-sensitive heading to the polls.

“We don’t take anything for granted in any election, especially not in a state like Arizona. However, this is a very intuitive, simple question for voters to understand,” Hall, executive director of the Justice Project, said. “The feedback from the electorate that we can gather so far is that there is overwhelming support for this issue across party lines and across the state, so we are very enthusiastic about the outcome.”

Opponents say the measure will do nothing to address basic health care costs, noting that not a single health care organization, including the state’s largest hospitals, has come out against the measure. But health experts say the ballot measure could help people deal with some of the long-term consequences of unpaid medical bills.

“These efforts help people with medical debt free up their monthly finances and give them some relief, but it doesn’t make people’s medical bills disappear or make health care cheaper,” said Krutika Amin, associate director of the Kaiser Family Foundation’s ACA program. . “While this helps people free up their finances, there is also the problem of affordability of health care.”

Eva Marie Stahl, vice president of public policy for RIP Medical Debt, a nonprofit that buys people’s medical debt so they don’t have to pay it, acknowledged that the measure only addresses part of the overall medical debt problem, but argued, “It’s worth chewing on rubber band and walking at the same time.’

“This is a really new approach, and it runs parallel to the Medicaid expansion campaigns,” said Stahl, whose nonprofit supported the measure. “This is a useful way to start a conversation with the public about medical debt. It’s really easy to understand. This applies to everyone. Even though we talk about this being a racial justice issue because it disproportionately affects black families in particular, it’s everyone’s issue.”