Arizona lawmakers debate cap on children’s health program

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Advocates for a health insurance program for children from low-income families are pushing lawmakers not to let Arizona once-again become the only state to freeze enrollment in the program.

Facing a daunting budget challenge during the Great Recession, Arizona capped enrollment in 2010. Lawmakers didn’t re-open it until 2016 and only with a strict limit — nobody new could sign up if the federal government stopped paying the entire cost.

The moment of reckoning is approaching on Oct. 1, when the federal government is scheduled to dial back its contribution to 90.5 percent of the program’s cost, requiring the state to pick up the other 10 percent. Lawmakers last year considered lifting the cap on the program that serves 33,000 children but did not act.

KidsCare covers children whose parents earn too much to qualify for Medicaid, between 138 and 200 percent of the federal poverty line. For a family of four, that’s between about $34,000 and $51,000 a year. Parents pay monthly premiums between $10 and $70 depending on their income and the number of children.

Sen. Kate Brophy McGee, a KidsCare program supporter who is co-sponsoring legislation to lift the enrollment freeze, said there was “enormous” resistance to re-opening the program two years ago. At the time, program supporters used procedural maneuvers to get around opponents who held senior positions in legislative leadership.

“As the program has unfolded and kids have benefited, I hope people are realizing the world hasn’t come to an end and that conditions are actually better,” Brophy McGee said. “I think we need to understand that we are investing in wellness for our children, which tees them up for success.”

During the debate over re-opening the KidsCare program, some Republican lawmakers said low-income families would become dependent on handouts if the program was restored. They rejected arguments that the federal government is covering the vast majority of the costs, noting the large federal deficit.

The last time Arizona froze enrollment in KidsCare, the number of children served dropped 60 percent and the waiting list swelled to 108,000 children in the first 18 months, though the state did not determine whether kids on the list were eligible for coverage, according to a report by the Kaiser Family Foundation.

Gov. Doug Ducey’s administration forecasts that 6,000 children who are eligible for KidsCare would not be able to sign up during the next fiscal year if the enrollment freeze takes effect, a number that would rise to 26,000 through 2022.

Ducey’s budget proposal includes $1.6 million to lift the freeze and cover the state’s share during the first year.

Hospitals are required by federal law to evaluate and stabilize anyone who shows up with an emergency. But supporters of the KidsCare program say that’s no way to treat chronic conditions like diabetes or asthma.

“When children are uninsured their families are unable to bring them in when they’re sick, so minor illnesses like colds can get exacerbated and ultimately they end up in the emergency department or even hospitalized for complications like pneumonia,” Dr. Jason Vargas, vice president of the Arizona chapter of the American Academy of Pediatrics, told lawmakers earlier this month.

Senate President Karen Fann, R-Prescott, said she’s personally supportive of lifting the enrollment freeze but added the state needs to be cautious about taking on the ongoing commitment.

“If we’ve got the money that we can do a little extra to help with important things like that, then absolutely,” Fann said.