What about the Children?

Health

WhataboutChildrenWhen Arizona Governor Jan Brewer signed the Medicaid expansion bill into law on June 17th, she said, “I know in my heart that we have made the right choice.” Expanding Medicaid for adults certainly was the right thing to do, but we must also ask, “What about Arizona’s children?”

While Governor Brewer and the Arizona legislature deserve credit for raising the Medicaid income level for adults, the exact opposite is true for children’s public coverage in Arizona – it’s going away!

In January 2010, the CHIP enrollment freeze began in Arizona with no new children being enrolled and scores of covered children dropping every day. Sure, the state saved $12.9 million but they also lost $41 million in federal funds AND close to 100, 000 children were placed on a waiting list for coverage. When the state created KidsCare II to help make up the difference, the program was designed to end on December 31st, 2013. Now, CHIP covers about 7,000 children, down dramatically from its once high point of almost 70,000 kids. KidsCare II covers about 30,000, and Arizona has a rising uninsurance rate for children at 13 percent, with a quarter of a million children going uncovered. And the future is even bleaker for Arizona’s low-income children. How can this be right?

With CHIP enrollment halted and KidsCare II expiring at the end of this year, children in Arizona are at risk on January 1, 2014. While coverage in Medicaid or the new health insurance marketplace may be an option for some of these children, a significant portion will not have any opportunity for affordable coverage due to the so-called “family glitch”.

The glitch precludes kids from getting subsidies if their parents have an affordable offer of self-only coverage through their jobs. In a quirk of the law, the Affordable Care Act says that workers and their families cannot be eligible for subsidized coverage in the exchanges if the employed worker has an affordable offer of coverage from their jobs. Unfortunately the test of whether coverage is affordable is based only on the cost of insuring the employee alone, and not the cost of coverage for the entire family, which is typically three times more expensive than the cost of employee-only coverage. This means that tens of thousands of Arizona kids are not only being locked out of CHIP and cancelled by KidsCare II, they also might not be eligible for subsidized coverage under the Affordable Care Act. If Governor Brewer is looking at doing the right thing, she and the legislature must take another look at restoring children’s coverage in Arizona.

Governor Brewer and the Arizona policymakers should do the right thing for kids: end the CHIP enrollment freeze and open up CHIP to all eligible children.