Arizonans can expect an effort this legislative session to restore KidsCare, a government insurance program for children whose parents earn too much to qualify for Medicaid.
Arizona is the only state in the country that does not have an active federal Children’s Health Insurance Program (CHIP), and children’s advocates say that’s why so many kids in the state remain uninsured. KidsCare is Arizona’s CHIP program.
KidsCare provides more comprehensive and affordable coverage than plans available to families on the federal health insurance exchanges, according to a report released Thursday by the Georgetown center and the Phoenix-based Children’s Action Alliance.
Officials with the children’s group say they are working with two state lawmakers on introducing a bill in the upcoming legislative session that would lift the KidsCare enrollment freeze.
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.
“Even with financial help, research shows that Arizona marketplace plans cost much more for families than KidsCare in most cases and may not offer benefits that are as comprehensive or child focused,” the report says.
That conclusion was backed up in a November report by the U.S. Centers for Medicare & Medicaid Services that found consistently lower out-of-pocket spending for children on CHIP versus those on health insurance marketplace (exchange) plans.
The report also said that benefit packages for CHIP are generally more comprehensive for “child specific” services such as dental, vision and therapy.
Tucson pediatrician Dr. Eve Shapiro says she currently sees uninsured children whose parents avoid taking them to the doctor unless it’s absolutely necessary. A pervasive problem is among working families that earn too much to qualify for Medicaid, and yet can’t afford plans and their associated out-of-pocket costs on the health exchange, she said.
“Normally their kids would be on KidsCare but it’s like they are in a hole and can’t access any insurance,” Shapiro said. “These are all working people. One of them has a child with ongoing medical problems. It is really a problem.”
Some families call wanting advice over the phone in order to avoid a bill, she said.
“That puts us in a difficult position as well,” she said.
The federal government would pay the cost of reinstating KidsCare, says Dana Naimark, president and chief executive officer of the Children’s Action Alliance.
“The KidsCare laws are still on the books. The federal Affordable Care Act doesn’t allow you to eliminate CHIP,” Naimark said. “Arizona snuck in because it had put the freeze in place before the Affordable Care Act was signed.”
At one time, KidsCare 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. In Arizona, Medicaid is called the Arizona Health Care Cost Containment System (AHCCCS).
Tucson resident Jennifer Linch’s children were once enrolled in KidsCare and she was happy with the coverage. They are now without coverage.
Linch’s husband works for a heating and cooing company and he is uninsured, too. Linch has insurance through her job as a medical assistant but adding dependents is too expensive and she could not find affordable plans on the health exchange.
“If I quit my job or had another baby, we’d be able to get AHCCCS,” said Linch, a 34-year-old mother of three. “But I don’t think I should have to do that just to get health insurance.”
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 775 children, according to the most recent AHCCCS data.
Many of the children previously eligible for
KidsCare are now eligible for AHCCCS coverage, while others are transferred to the marketplace where their families can enroll them in coverage, said Daniel Ruiz, a spokesman for Gov. Doug Ducey.
“The governor is receptive to ideas to improve coverage so long as the options are fiscally responsible and provide reliability and certainty in health-care matters,” Ruiz said.
