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KidsCare enrollment cap concerns advocates

Author: chris walker
Author: chris walker

As part of a measure to save the state $3 million this fiscal year, lawmakers have capped enrollment in KidsCare, an insurance program for children who dont qualify for AHCCCS, the states Medicaid program.

The decade-old program was created by Congress and funded through a 75-25 split between federal and state funds.

It gives access to health insurance to families that make too much money for Medicaid but may not have insurance through their jobs or the ability to pay for it privately.

There are income restrictions tied to the program, depending on a childs age. Parents pay a low monthly premium for the insurance.

Currently, 46,861 children statewide are on KidsCare. It was targeted during the most recent budget cuts to help bring Arizonas spending in alignment with projected revenue. The state is still facing a $1.5 billion shortfall this fiscal year, which ends next June 30. Lawmakers will continue work on the issue in January.

By capping enrollment in KidsCare, the state isnt saving much, but its doing a great deal of harm, said Matt Jewett, an official with the Childrens Action Alliance, a state advocacy group.

At this economic time its most needed. It helps keep families out of debt. We know nationwide in 60 percent of bankruptcy cases, health care costs are a primary factor, Jewett said. (KidsCare) is very good at keeping families out of medical debt. It helps kids to grow up healthy and get the preventive care they need. Its very concerning to us.

According to the plan, the families now on KidsCare can remain as long as parents maintain their monthly premiums and annual renewals, and as long as they still qualify.

In fact, the number of children in the program has dropped significantly in the last two years because many of those working families have lost their jobs and now qualify for Medicaid.

In December 2008, there were 64,377 children enrolled in the program. Since March, about 20,000 children on KidsCare have become Medicaid eligible, according to the AHCCCS Web site.

Between 3,000 and 5,000 children a month drop off the rolls of KidsCare because they no longer qualify or their families did not renew or pay the premium, said Monica Coury, assistant director of the Office of Intergovernmental Relations for the Arizona Health Care Cost Containment System, which administers the KidsCare program.

With the cap in place, Kids-Care enrollment could drop to 28,000 children by June from the current 46,861, resulting in the projected $3 million in savings for the state, she said. The federal government will save about $10 million because it will not be contributing to the costs for new enrollees.

According to the AHCCCS Web site, thousands apply for the program each month. Those families that qualify will now be put on a waiting list indefinitely, Until theres sufficient funding to cover the program, Coury said.

Rhonda Anderson, CEO of Cardon Childrens Medical Center in Mesa, said the hospital always treats patients when they arrive, without asking about insurance or ability to pay. That wont change.

Her concern, she said, is what happens to the children when they leave the hospital. Without insurance, follow-up care could be disregarded, she said.

From a physicians perspective, who will be caring for them if they have no way to pay and no opportunity for any type of coverage? That is really the bigger dilemma for the community at large. Then usually what happens and weve seen these types of cycles throughout the U.S. they avoid getting care until theyre really, really sick and sometimes those illnesses are reversible. Thats the dilemma were in for children in this state, Anderson said.

In 2009, 46 percent of the patients at Cardon Childrens Medical Center were under an AHCCCS program, she said. Anderson said she does not know what the financial impact to the hospital will be if more children arrive without health insurance.

Anderson also sits on the board for the Childrens Action Alliance.

Unlike some other state health programs, KidsCare is not voterapproved. That is one reason it can be cut, the alliances Jewett said.About the Author:

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