Arizona is the only state without an active federal Children’s Health Insurance Program, and the impact has been negative for low-income families, two new studies suggest.
Fourteen thousand children in Arizona lost their health insurance at the end of January 2014 when the state ended its KidsCare program for low-income children, becoming the only state in the country without an active CHIP program, Georgetown researchers found.
The reports, released Friday by the Georgetown University Center for Children and Families, found that Arizona families experienced chaos, confusion and disruptions in care for their children after the program ended.
Some children went without needed care or had to stop taking prescribed medications because their families could no longer afford them, the reports said.
The reports are timely because federal money for CHIP runs out in September and Congress must decide whether to renew it.
“Arizona’s experience suggests that if CHIP funding is not extended or the program itself is fundamentally changed, our nation’s historic gains in covering children could unravel, making many children worse off than they are today,” Georgetown University Center for Children and Families senior program director Elisabeth Wright Burak wrote in “Children’s Coverage in Arizona: A Cautionary Tale for the Future of the Children’s Health Insurance Program.”
The report noted that Arizona ranks 49th nationwide for percentage of uninsured children, a ranking likely tied to its rejection of CHIP.
In Arizona, the Children’s Health Insurance Program is called KidsCare. At one time it enrolled nearly 50,000 children from low-income families whose parents earned slightly more than the cutoff for Medicaid, a government health insurance program for extremely low-income people.
Another program also covered the parents of children on KidsCare. But in a series of budget-cutting decisions, the Arizona Legislature decided to end coverage for KidsCare parents in 2009 and the following year froze enrollment in KidsCare. By July 2011 the KidsCare waiting list had grown to more than 100,000 children.
A temporary KidsCare program, KidsCare II, was created in 2013, but expired when most provisions of the federal Affordable Care Act took effect at the end of January 2014. Enrollment in KidsCare remained frozen and is expected to dwindle to zero. KidsCare now enrolls fewer than 2,000 children, state data show.
The program is expected to stop operating altogether once the current enrollees either age out of the program or give up coverage because their family income changes or for other reasons.
The Phoenix-based Children’s Action Alliance would like to see the program restored.
Arizona’s Medicaid program is called AHCCCS, the Arizona Health Care Cost Containment System. AHCCCS spokeswoman Monica Coury had not yet seen the reports when contacted Friday afternoon and declined comment.
In 2013, Coury told the Star that families no longer able to get KidsCare could go to the federal marketplace where they would be able to buy private health insurance and possibly qualify for federal subsidies to help pay for it.
Also, since the state expanded AHCCCS eligibility to 138 percent of the federal poverty level, some KidsCare children were able to qualify for AHCCCS. Indeed, that’s what happened with about 23,000 children who transferred from KidsCare II and KidsCare to AHCCCS.
But the new reports say the insurance status of the 14,000 children who lost coverage and did not qualify for AHCCCS is unclear.
The second report, “Living Without KidsCare: Insights From Parents of Children Who Lost Their Health Coverage When Arizona Scaled Back Its Children’s Health Insurance Program,” is based on focus group research and interviews conducted by PerryUndem Research and Communication.
Joseph Fu, director of health policy at the Children’s Action Alliance in Phoenix, helped identify and recruit families who had lost coverage.
The families interviewed said they liked KidsCare, were not prepared when it ended and wanted it to be restored.
Families whose incomes were too high for AHCCCS struggled the most as they found the alternatives costly. Some children went without health insurance, without medication and without medical treatment, the report says.
