Restoring government-funded health insurance to the children of working poor families in Arizona received unanimous support from a state House committee Tuesday.
HB 2309 would lift the freeze imposed on enrollment in KidsCare, which is Arizona’s version of the federal Children’s Health Insurance Program known as CHIP. Arizona is the only state in the country without an active CHIP program.
Dr. Elizabeth McKenna, a pediatrician, pointed out to members of the House Health Committee that Congress has agreed to pick up the full cost of the program through 2017. She said there’s no reason for the state to reject the money and leave children without coverage.
But the measure, which now goes to the House Appropriations Committee, faces an uncertain future amid concerns that the state will end up obligated — whether legally or politically — to pick up the cost once the federal government stops picking up the entire tab.
Before it was frozen, KidsCare provided health care to low-income children in families with incomes from 138 percent to 200 percent of the federal poverty level, or $27,000 to $40,000 for a family of three.
Arizona has had a freeze on KidsCare since 2010. Advocates of the program say those families are finding health insurance that’s available on the federal marketplace is out of their budget, even with federal subsidies.
“You are almost disincentivized from working,” said committee Chairwoman Heather Carter, a Republican from Phoenix.
“As an emergency physician in Arizona, it’s a tragedy we are not providing (KidsCare) in our state,” said committee member and Minority Leader Dr. Eric Meyer, a Democrat from Paradise Valley.
While taxpayers still technically pay for the program through federal dollars, Meyer said Arizona should use its share and prevent it from being redistributed to other states.
The bill still has more hurdles. The governor’s office is reviewing KidsCare, along with specific legislative proposals, said Daniel Scarpinato, a spokesman for Gov. Doug Ducey.
“We are mindful of any impact on ongoing state revenues and the flexibility of the state to make decisions in regard to our budget moving forward,” he said.
Supporters say KidsCare provides much needed health coverage for children of families who make too much to qualify for Medicaid.
Arizona’s Medicaid program is called the Arizona Health Care Cost Containment System, or AHCCCS. Arizona’s rate of uninsured children is 10 percent, the third highest rate in the country — only Texas and Alaska are worse, according to Georgetown University’s Center for Children and Families.
The national rate of uninsured children is 6 percent.
Advocates for children say Arizona’s lack of a CHIP program is fueling its rate of uninsured children.
The bill is sponsored by Republican Rep. Regina Cobb, a dentist from Kingman who is also a member of the House Health Committee. A similar bill has been introduced in the state Senate. An amendment approved Tuesday gives the director of the state’s Medicaid program the option of stopping the program if the federal government stops covering the entire cost.
“This is probably the least of the hurdles we are going to see in the next month,” Cobb said after the committee’s vote. Among those who testified in support of restoring KidsCare were representatives of the March of Dimes and the American Academy of Pediatrics’ Arizona chapter.
At one time, KidsCare enrolled nearly 50,000 children . In a series of budget-cutting decisions, the Legislature in 2010 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 in January 2014.
Enrollment in KidsCare remained frozen and is expected to dwindle to zero. KidsCare now enrolls 730 children, according to the most recent AHCCCS data.
At the time the Legislature froze the program, Arizona had to provide federal matching funds for KidsCare. But currently, the federal government would provide all of the costs, supporters said this week.
Arizona Rep. Randall Friese, a Democrat from Tucson, wanted to know whether Arizona would face any kind of spending cap. Kelly Whitener, a researcher from Georgetown’s Center for Children and Families, responded that a generous federal fund exists to cover the cost of states who exceed projected spending. She added that given current trends, it’s likely the federal government would extend funding through 2019.
KidsCare provides more comprehensive and affordable coverage than plans available to families on the federal health insurance exchanges, according to research by Georgetown University and the Phoenix-based Children’s Action Alliance.
“The image of Arizona is harmed by being the only state to turn our backs on children, who are our future,” testified Dr. Leonard Kirschner, former director of AHCCCS and past president of the AARP in Arizona.
