HB 4145 Arizona House · 57th Legislature - Second Regular Session

2026-2027; health care.

This bill establishes stricter rules for verifying eligibility for Arizona's health care system by requiring the state to match member data with tax and gambling records to detect undisclosed income. It mandates quarterly checks on able-bodied adults and prohibits the use of self-reported information for enrollment without independent verification from state agencies. Additionally, the legislation seeks to limit presumptive eligibility for adults, restricting it primarily to children and pregnant women, while setting specific performance standards for hospitals that make these temporary determinations. If hospitals repeatedly fail to meet these standards, the bill requires mandatory staff training or revokes their ability to make presumptive eligibility decisions. Although the bill passed the legislature, it was vetoed by the Governor.
Bill status vetoed 4 of 5 stages cleared
Introduction
Apr 2026
Committee Review
Apr 2026
House Passage
Apr 2026
Senate Passage
May 2026
Vetoed
May 2026
Introduced Apr 27, 2026 Vetoed May 5, 2026
Maddy AI version diff · 1 comparison

What changed between versions

Introduced Version House Engrossed Version (04/29/2026) · 5 edits · May 4, 2026
MODERATE
The bill was reformatted from a standard legislative introduction to an official House Engrossed version, adding specific statutory text and funding details. Substantively, the bill introduces new data-matching rules to verify member eligibility against lottery winnings and tax records, mandates quarterly redeterminations for able-bodied adults, and establishes a new penalty system for hospitals that fail to meet presumptive eligibility standards.
Scope change
The bill's scope expanded to include specific enforcement mechanisms for hospitals regarding presumptive eligibility and detailed funding allocations for counties and state hospitals for the 2026-2027 fiscal year.
ELIGIBILITY

Added requirements for the administration to match member data against lottery and gambling winnings of $3,000 or more and tax records to verify eligibility.

REQUIREMENT

Mandated quarterly redetermination of eligibility for able-bodied adults who are not American Indians or Alaskan Natives.

ENFORCEMENT

Created a tiered enforcement system for hospitals making presumptive eligibility determinations, including mandatory staff training for second violations and disqualification from the program for third violations.

FISCAL

Specified exact dollar amounts for county contributions to the long-term care system and disproportionate share payments for state and private hospitals for fiscal year 2026-2027.

TIMELINE

Set an effective date of December 31, 2026, for the new statutory sections regarding data matching and presumptive eligibility.

Floor votes · House Apr 29, 2026

How they voted

This bill passed the Senate by voice vote (no roll call recorded).
Full legislative history

Actions timeline

Total actions
11
Key actions
4
Committee
1
May 5, 2026
Vetoed
Vetoed by Governor
executive
May 4, 2026
Upper · Passed
PASSED
upper
Apr 29, 2026
Lower · Passed
PASSED
lower
Apr 29, 2026
Lower · Passed
DP
lower
Apr 28, 2026
Lower · Passed
DP
lower
1 primary · 4 co-sponsors

Sponsors