Category: Health

Big Win! Final Public Charge Rule Announced

Last week, the Biden Administration announced changes to immigration rules that disproportionately harm low-income people of color.  

The changes repeal and replace extreme and discriminatory changes to the Public Charge determination process, which we and so many other Arizona advocates and allies have fought for years.  

This is a victory for Children’s Action Alliance, the Arizona Center for Economic progress, and our countless partners who are fighting for a country where all families have the tools and resources to thrive. The new Public Charge rule aligns with longstanding principles in immigration law and makes clear that the use of publicly supported health, nutrition, or housing programs will not be considered by federal officials as part of the green card application process.  

This rule cannot and will not erase years of harm, fear, and mistrust that have stopped thousands of Arizona families from getting supports they deserve, but we hope that it’s a vital step toward healing and a new pathway for foreign-born immigrants– one that acknowledges the dignity and worth of every Arizonan. 

 

Your voice is needed to get 2022 health wins over the finish line

CAA and our partners worked hard this year to get the legislature to approve changes to our Medicaid and CHIP programs (AHCCCS and KidsCare). Thanks to your advocacy, the legislature passed bills making it easier for people to access high quality, affordable health coverage.   

Now AHCCCS needs our help to get these changes over the finish line!  

Postpartum coverage: The state legislature passed a bill extending postpartum Medicaid coverage period from just 60 days to 12 months after pregnancy. AHCCCS is accepting public comments on this measure until August 29th. This is a final step before the extension can be implemented, and we want them to know we are supportive! Postpartum coverage omments can be submitted by email to publicinput@azahcccs.gov. 

EPSDT: AHCCCS is also proposing several important changes to its Early and Periodic Diagnostic, Screening and Testing (EPSDT) policies. We believe these changes will support child and family health and promote equity. The public can view and submit your thoughts on the proposed changes via this portal. Comments on these changes are due by September 1st 

It’s important that we go on record to tell our Medicaid agency why these changes are needed and how they will benefit our communities.  

If you’re not sure where to start, feel free to download and modify our template comments (linked here).  

2022 KidsCount Data Show AZ Children are in Crisis

Children in the United States are experiencing anxiety and depression at alarming rates, per the newly released 2022 KIDS COUNT® Data Book, a 50-state report of recent household data released today by the Annie E. Casey Foundation.  

In the year before the COVID-19 pandemic, 9% of U.S. high school students attempted suicide. This is alarming on its face – but the Kids Count data also show significant disparities in adolescent suicidality by race, ethnicity, sexual orientation, and gender identity. For example, 12% of Black students, 13% of students of two or more races, 23% of gay, lesbian, or bisexual students, and 26% of American Indian / Native Alaskan students attempted suicide.

The KidsCount Data Book looks at multiple indicators and data sources to rank how children and families are faring in each state. The report ranked Arizona 44th in the nation when it comes to economic well-being, health, and family and community support.  

The report also proposes solutions to the systemic barriers to accessing mental health care and other supportive services, particularly for BIPOC and LGBTQ+ students.  

As the pandemic took hold, diagnoses of depression and anxiety increased markedly in 3-7 year olds across the country – but decreased in Arizona from 11.7% to 10.8% between 2016 and 2020. While fewer children in our state are being diagnosed with these conditions, additional research is needed to determine whether this is a true improvement in mental health status or simply a symptom of insufficient access to health care.  

The report shows other alarming trends in Arizona: higher child and teen death rates, more children living in families where no parent has full-time work, more children without health insurance, and fewer high school students graduating on time are higher than the national average. Though the poverty rate has fallen to an average of 20% throughout our state, it remains higher than the national average of 17%.  

The Annie E. Casey Foundation, Children’s Action Alliance, and the AZ Center for Economic Progress recommend the following solutions to keep children mentally and physically healthy:  

  • Prioritize meeting kids’ basic needs. Youth who grow up in poverty are two to three times more likely to develop mental health conditions than their peers. Children need a solid foundation of nutritious food, stable housing, and safe neighborhoods — and their families need financial stability — to foster positive mental health and wellness. 
  • Ensure every child has access to the mental health care they need, when and where they need it. Schools should increase the presence of social workers, psychologists and other mental health professionals on staff and strive to meet the 250-to-1 ratio of students to counselors recommended by the American School Counselor Association. Currently, Arizona ranks last in the nation with a 716-to-1 ratio.  
  • Bolster mental health care that considers young people’s experiences and identities. Care should be trauma-informed — designed to promote a child’s healing and emotional security — and culturally relevant to the child’s life. It should be informed by the latest evidence and research and should be geared toward early intervention, which can be especially important in the absence of a formal diagnosis of mental illness. 

2022 National Kids Count Report

Happy Birthday to the Children’s Health Insurance Program!

Today marks a special anniversary: the Children’s Health Insurance Program (CHIP) is 25 years old. The program, known as “KidsCare” in Arizona, has established itself as a critical federal-state partnership to meet children’s health care needs.  

Arizona hasn’t always embraced the program. In fact, for years Arizona was the only state in the US without an active CHIP. But that doesn’t mean we haven’t reaped its benefits.  

Over the past 25 years, CHIP and Medicaid have sharply reduced the rate of uninsured children—in Arizona, the child uninsured rate dropped from 16% in 2008 to 9% in 2019, despite a lengthy KidsCare enrollment freeze. 

KidsCare covers kids whose families earn too much to qualify for Medicaid (AHCCCS) but too little to afford private health insurance. Together with Medicaid (AHCCCS) and the Affordable Care Act, KidsCare works to provide no- or low-cost health coverage for kids - including doctor and dentist visits, immunizations, prescriptions, emergency care, and more. These programs work together to meet children’s health care needs and ensure that no one is left behind.  

As we mark the anniversary of CHIP’s federal passage into law this week, we celebrate a bipartisan commitment to caring for our nation’s kids. We must renew this commitment and permanently fund CHIP so that states like Arizona can successfully and responsibly keep KidsCare running, and kids can get the care they need.  

READ MORE:

When the COVID-19 continuous coverage protections are lifted, thousands of children in Arizona are at risk of becoming uninsured. This will disproportionately affect BIPOC children, children living in rural Arizona, and – importantly – families who participate in KidsCare.  

That’s why Children’s Action Alliance worked with state lawmakers to pass legislation protecting coverage for children who participate in our CHIP program during the 2022 Legislative session.  

HB2551 – sponsored by Representative Regina Cobb – helps cut through the red tape and burdensome paperwork requirements. It will ensure that children who qualify for KidsCare can stay continuously covered for a full year – even if their household’s circumstances temporarily improve.  

Looking ahead, Arizona can do more to help children thrive by removing barriers to enrollment in AHCCCS and KidsCare. We must: 

  • Make CHIP funding permanent at the federal level, so kids health care isn’t used as a political bargaining tool. 
  • Raise the income limit for KidsCare to at least the national median of 255% FPL. 
  • Remove monthly KidsCare premiums.  
  • End the 3 month wait period for KidsCare coverage. 
  • Expand coverage options for immigrant children. 
  • Ensure children who participate in AHCCCS are also guaranteed twelve months of continuous coverage.  

Save Home Visiting

The early childhood community celebrates a huge win in the Arizona state budget! The final version of the budget invests $10 million dollars to fill the funding gap and expand the Healthy Families Arizona (HFAz) home visiting program.  HFAz is designed to help expectant and new parents get their children off to a healthy start. Program services are designed to strengthen families during the critical first years of a child’s life – the time when early brain development occurs, laying the foundation for a lifetime of memories, behaviors, and outcomes. Through its efforts to support and educate families, the program has shown to reduce incidences of child abuse and neglect, provide stability for at-risk families and has grown a new generation of healthy families in the state.1 Back in 2009, monies supporting HFAz were cut from the state general fund and have not been replaced since. We are thrilled to see that Arizona legislators recognize the essential value HFAz provides for Arizona families and applaud the new $10 million dollar investment.  

Now that we have secured this investment in home visiting for Arizona children, the next step is to advocate on behalf of children in every state! We are less than 100 days out from the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) reauthorization deadline. The MIECHV Program supports families with the tools and resources they need to thrive. This program is bi-partisan and evidence based and builds upon decades of scientific research showing that home visits by a nurse, social worker, early childhood educator, or other early childhood professional during pregnancy and early childhood significantly improves life outcomes of children and families. Congress has a lot on their plates, but we want to make sure that MIECHV reauthorization is top of mind as we approach the expiration of the current funding on September 30th. We are asking early childhood advocates and stakeholders to do two things.   

First, contact your members of Congress by clicking HERE and then please use this 100 Days Social Media Tool Kit to create a sense of urgency on Capitol Hill. Now is the time to rally together and let our Senators and Representatives know that it’s time to take action on MIECHV!  

Abortion is More Than Health Care

Children’s Action Alliance envisions an Arizona where all children and families can thrive. We cannot stay silent about today’s decision by the Supreme Court of the United States to overturn Roe v. Wade.

Today’s decision will not stop abortion in our state – not for those with resources. But it will prevent Arizonans from exercising their right to make informed decisions about their health care, maintain autonomy over their bodies, and to choose when and how to start a family.

Abortion is health care – and it’s so much more. Abortion is financial security. It’s an education. It’s the ability to plan for a better future. Without that choice, Arizonans will continue to fall prey to a system that’s designed to benefit those with means by harming those without.

For over three decades, CAA has been advocating for children and families. For over three decades, our state lawmakers have systematically denied these families the tools to build a better future. There has rarely been anything “pro-life” or “pro-family” about how our state invests its resources.

Since our nation’s founding, Black, Indigenous, and People of Color have been forced to fight for the most basic of rights: control of their own bodies. From slavery and colonization to the Tuskeegee study and forced sterilization to today’s unacceptable maternal mortality rates for BIPOC individuals, the United States government and its institutions have maintained White supremacy through conscious restriction of reproductive rights.

The state of Arizona is equally complicit in this subjugation.

Each year Arizona receives millions in federal TANF dollars. Most states use these funds to provide flexible assistance to families struggling to afford rent, utilities, diapers, medicine. But only a tiny portion of Arizona’s TANF money is invested in keeping families clothed, fed, and housed. The lucky few who do receive assistance through the program are wound up in red tape and reporting requirements and lose access to aid after just two years.

It's no wonder, then, that Arizona families struggle to pay rent, put food on the table, and provide the essentials. And it’s no wonder that 92% of DCS referrals are not a result of physical or sexual abuse, but neglect – insufficient shelter, poor nutrition, inadequate childcare, unmet medical needs.

Seven in ten Black children in Maricopa County will experience a DCS investigation at some point in their childhood, and Black parents are four times as likely to have their parental rights severed by the state. Arizona’s standard TANF payment for a family of four is just $335 per month; by contrast, foster parents in the state are paid an average of $700 per child per month, which does not include additional costs assumed by the state when a child enters DCS care.

It should not come as a surprise that the vast majority of foster caregivers in the state are White.

It’s not just a lack of financial assistance that hinders Arizona families’ ability to be well and stay together. Inequity is baked into our health care systems. One in four American Indian children in Arizona is uninsured, despite being disproportionately likely to qualify for AHCCCS or KidsCare; though centuries of treaties are supposed to assure Tribal members access to health care, the US government has never adequately funded the Indian Health Service or other Tribal health programs. Unsurprisingly, Indigenous individuals in Arizona are nearly four times as likely to die during or in the year after pregnancy. Despite being more likely to work year-round, Latinx households are less likely to have access to employer-sponsored health coverage. Black and Latinx children are more likely to be impacted by chronic diseases like Asthma, but less likely to have access to preventive care to keep them out of the hospital and stave off medical debt.

Today’s decision reminds us why it is so critical for Arizonans to select leaders at every level who will prioritize health care, economic supports, and reproductive justice.

Operation: Affordable Healthcare

Any toddler will tell you that a band-aid can fix most problems - but really big boo-boos need really big solutions. That’s why we’re launching Operation: Affordable Healthcare, a campaign to help heal the American healthcare system. The mission? Access to affordable, high-quality healthcare for all.

The Operation: Affordable Healthcare policy plan will expand access to care, empower consumers, and promote health equity in Arizona and beyond. By reinforcing the foundation laid by the Affordable Care Act, Families First Coronavirus Response Act, and American Rescue Plan Act, we can start to fix what’s broken in the U.S. healthcare system.

Will you join us?  

We’re calling on Arizona Senators Kelly and Sinema to take bold steps to promote access to affordable care. 

Operation: Affordable Healthcare policy priorities

  1. Close the family glitch to open Marketplace health coverage to families paying too much for dependent coverage through their employer-sponsored health plans.
  2. Extend the American Rescue Plan Act’s health care affordability provisions beyond 2022 to ensure everyone can get the care they need without breaking the bank.
  3. Require Medicaid to cover people for twelve months after pregnancy (Arizona is on its way to making this happen at the state level! Please take a minute to let your legislator know it’s important that this is funded in the state budget.)
  4. Cover Arizonans fully from toe to top – mental health, oral health, and all the rest. Medicaid and Medicare should cover the whole person at parity.
  5. When children qualify for Medicaid or CHIP they should be continuously covered for a full year – no more pesky paperwork for hardworking Arizona families.
  6. Save Arizona families money at the pharmacy by allowing Medicare to negotiate prescription drug prices.
  7. Play for keeps; make permanent funding for the Children’s Health Insurance Program (CHIP; KidsCare in Arizona).

AZ families could be dropped from health care (and don't even know it)

Early in the pandemic, the federal government issued a Public Health Emergency (PHE) declaration. This allowed the government access to funding and procedural flexibilities to help control the COVID-19 crisis. One of many such flexibilities was the decision to stop disenrolling people from Medicaid and the Children’s Health Insurance Program – known as AHCCCS and KidsCare in Arizona.

As cases continue to drop nationwide, it’s likely that the PHE will expire as soon as this summer, and AHCCCS and KidsCare will return to business as usual.

Over the past two years, youth enrollment in AHCCCS and KidsCare has grown by nearly 100,000 children. As of March 2022, 49% of children in Arizona have health coverage through Medicaid or CHIP. Compared to their uninsured peers, children covered by these programs are more likely to do well in school, graduate from high school, earn more as adults, live longer, and even give birth to healthier infants in the next generation.

In order to stay enrolled, families will need to respond swiftly to requests for information from AHCCCS. By AHCCCS’ own estimation, half a million Arizonans are at risk of losing coverage at the end of the PHE, either because they no longer qualify or because they have been unreachable by mail.

We’re working to get the word out about this change to families throughout Arizona. Will you help us?

We need all hands on deck to keep kids covered.

  1. Families with coverage through AHCCCS or KidsCare should verify that their contact information is up to date. They can do this by logging into Health-E Arizona Plus or by calling AHCCCS at 1-855-432-7587 or TTY 1-800-842-6520.
  2. Help with enrolling, re-enrolling, or identifying a new health coverage source is available throughout Arizona. Families can schedule a free appointment with an enrollment assister by calling 2-1-1 or visiting coveraz.org/connector.
  3. We’ve created social media materials in five languages, as well as talking points for educators and health care providers about the change. Please share widely. Print materials are also available by request.
  4. If you’re interested in scheduling a presentation on the change and what it means for Arizonans, please email Health Policy Director, Zaida Dedolph Piecoro.
  5. If you’d like to support this effort, please consider making a monthly gift to CAA. Your support will help us amplify this message.

AZ kids are at risk of losing health coverage

The Families First Coronavirus Response Act of 2020 temporarily increased the federal government’s share of Medicaid costs. In return, states are prohibited from disenrolling anyone from Medicaid or CHIP (AHCCCS or KidsCare in Arizona) unless they move, die, or request to be disenrolled. This has kept many children and families from losing coverage. As the pandemic begins to wane this temporary relief will end and our state leaders must act swiftly to #KeepAZKidsCovered.

A new report by the Georgetown Center for Children and Families (CCF) shows that 851,574 children - nearly half (49%) of all children in Arizona - were enrolled in AHCCCS or KidsCare in 2021.* Between February of 2020 and June of 2021, enrollment in these programs increased by nearly 100,000 children.

We’ll be hosting a Facebook Live discussion to explore how advocates can help minimize coverage loss in their communities, as well as steps our state policymakers can take to #CoverAZKids and #KeepAZKidsCovered.

The federal public health emergency could expire in the next few months, at which point AHCCCS will resume their standard renewal practices and disenroll people who fail to respond or who no longer qualify. By AHCCCS’ own estimates, 500,000 people are likely to be disenrolled after the public health emergency ends. Many of these individuals are likely still eligible for coverage, but have fallen through the administrative cracks.

What can our leaders do to #KeepAZKidsCovered? Here are a few ideas to start:

  1. Invest in health care outreach and enrollment support (CoverAZ.org and 2-1-1 can help families find coverage year-round!)
  2. Boost AHCCCS funding to ensure the agency is fully equipped to assist applicants and process renewals.
  3. Increase income eligibility for KidsCare to ensure kids have access to quality health care while their families build a solid financial foundation.
  4. Provide continuous enrollment for children enrolled in AHCCCS and KidsCare, so children who that qualify at any point in the year can stay connected to care even if their household income fluctuates.
  5. Offer transparent access to state disenrollment data, so advocates can engage in targeted outreach to families who lose coverage.

*Arizona does not provide detailed data on children’s AHCCCS or CHIP enrollment to the federal government. CCF relied on administrative reports to make this estimation. See “Methodology.”