Category: Health

This is our rainy day – why isn’t Arizona investing in children’s health?

The American Rescue Plan Act, or ARPA, went into effect on March 11. The effort passed through Congress with several provisions that will make it easier for Americans to get high-quality, affordable health coverage. Notably, the plan increases and expands premium subsidies for health coverage through Healthcare.gov, the Affordable Care Act Marketplace. As a result, 207,000 uninsured adults can now enroll in Marketplace health coverage at no cost.

The premium subsidy increase is a tremendous move in the right direction. Unfortunately, at this point the increase is a temporary fix to larger problem of health care affordability in the U.S.

Arizona’s lawmakers must act to provide permanent relief to Arizona families by expanding eligibility for KidsCare, Arizona’s Children’s Health Insurance Program. The state’s rainy-day fund carries a balance of roughly a billion dollars, and tax revenues continue to outpace expectations. As we’ve noted previously, an infusion of federal relief funds saved AHCCCS (which administers KidsCare) $153 million in state fiscal year 2020 alone.

And yet, more than 161,000 uninsured Arizona children – the majority of whom are American Indian and/or Latino/a – live in households earning just slightly too much to qualify for the high-quality, low-cost health coverage provided through KidsCare.

Insuring children is an investment in Arizona’s future. When uninsured kids have access to coverage through Medicaid or CHIP, they come to school ready to learn. They’re more likely to graduate from high school and pursue secondary education. They earn more as adults, and are more likely to give birth to healthier infants than those who remained uninsured throughout childhood.

That’s why we’re urging our followers to contact lawmakers now and ask that they expand KidsCare income eligibility in the state budget. To make it easier for you, we’ve put together a click and send advocacy platform – just put in your name and address, and the system will do the rest.

Want to do more?

State lawmakers should expand KidsCare eligibility ASAP

A year into a pandemic that has claimed the lives of more than 16,000 Arizonans, the state legislature has repeatedly declined the opportunity to provide low-cost, comprehensive health coverage to tens of thousands of children. CAA’s new fact sheet explores why this measure is so important – and how many children would benefit.

In 2019, Arizona ranked 48th in the US for the rate of children’s health coverage. Latinx, American Indian, and Asian/Pacific Islander children are more likely to be uninsured than their peers of other races and ethnicities, and coverage gains for children of color facilitated by the Affordable Care Act have been eroded significantly over the past four years.

Unsurprisingly, our state also has one of the lowest income eligibility thresholds for its Children’s Health Insurance Program (CHIP; known as KidsCare in Arizona). KidsCare covers children up to age 21 whose families earn too much to qualify for Medicaid. Currently, a family of four earning up to 205% FPL ($53,004 per year) may qualify for KidsCare. For comparison, the national median upper income threshold is 255% FPL, or about $67,575 per year.

In 2019 (the last year for which we have comprehensive data), over 16,000 uninsured Arizona children currently lived in households earning slightly too much to qualify for KidsCare. The COVID-19 pandemic has inevitably increased the number of uninsured Arizona children, and may have strained the finances of families with health coverage through their employers or the Health Care Marketplace.

At the same time, the state is receiving an influx of federal relief dollars. In state fiscal year 2020 alone, the state is anticipated to have saved $153 million in state funds earmarked for AHCCCS (which administers KidsCare).

HB2273 (Children’s health insurance program; eligibility), sponsored by Representative Kelli Butler (D-LD28) would have expanded income eligibility. This bill was never heard in committee. Subsequent attempts to insert this provision have failed to gain traction.

Lawmakers will have another opportunity to provide health coverage to thousands more Arizona children by including the expanded KidsCare eligibility in the state budget. We hope they do.

Good ideas that didn't fit the bill

The Arizona legislature set a deadline that any bills that did not receive an initial committee hearing by the end of last week cannot advance this session. Committee chairs wield a lot of power in deciding which bills receive consideration or not and with 1,823 bills introduced this session, we understand there simply is not enough time to hear every bill. But there were several good ideas that would improve the lives of Arizona’s children and families introduced this year that never had the opportunity to be considered in committee. Even though time has run out this year for those bills, we want to take a moment to highlight a few of those good ideas that merit stronger consideration in the future:

  • HB 2416: Sponsored by Representative Pawlik to appropriate $13 million for child care to raise reimbursement rates. Arizona’s child care assistance program continues to reimburse providers for care at rates that are far below what it costs to actually provide that care. Parents often have to pay the difference between the reimbursement rate and the cost, making accessing child care too expensive even for many low-income families who are eligible for the program.
  • HB 2291: Sponsored by Representative Osborne to provide comprehensive dental care to eligible pregnant women. Pregnant women are especially vulnerable to developing oral health problems, which if left untreated are associated with adverse birth outcomes and increased risk of dental disease in early childhood.
  • HB 2273: Sponsored by Representative Butler to increase income eligibility for KidsCare, Arizona’s health insurance program for low-income children, from 200 percent of the federal poverty level to 300 percent of the federal poverty level. Arizona currently has one of the lowest income eligibility thresholds for its children’s health insurance program in the nation. After years of progress toward reducing the rate of uninsured children, Arizona has taken an unfortunate turn. Between 2016 and 2019, the number of uninsured children grew by roughly 22%. In 2019, 161,000 Arizona children were uninsured – the fourth highest rate of uninsured children in the United States.
  • HB 2659: Sponsored by Senator Marsh to establish an annual conference on children and youth to identify and recommend policy solutions to the legislature that will improve the lives of children in Arizona.
  • HB 2146, HB 2147, HB 2148, HB 2283, HB 2566, SB 1098, SB 1736, SB 1737: Sponsored by Representatives Friese, Lieberman, and Bolding; and Senators Alston and Bowie. Several bills were introduced this session to provide much-needed reform to the private school tuition tax credit program which diverts public tax dollars to private schools. These bills would restrict use of these tax credits to low-income families and would limit the amount which can be used for administrative costs. The expansion of private school tuition tax credits has had a significant impact on reducing state revenues growing from a cost of $14 million in 1999 to $177 million in 2019.
  • HB 2728: Sponsored by Representative Sierra to make participation in extended foster care until the age of 21 an opt-out rather than opt-in program for youth aging out of foster care when they turn 18. Extended foster care can provide a better bridge to adulthood especially during the current health and economic crisis.
  • SCR 1017: Sponsored by Senator Quezada. A legislative proclamation identifying racism as a public health crisis affecting our entire society and avowing to support policies that reduce racial and ethnic health inequities and promote social justice.

The list above is not an exhaustive list. We are glad to see so many lawmakers introducing bills this session that will benefit Arizona’s children, and we hope many of those bills become law in the future.

Image source: ABC's Schoolhouse Rock

Healthcare.gov will re-open for a special enrollment period

The Biden administration has announced that it will reopen the federal ACA Marketplace for a special enrollment period in response to the COVID-19 pandemic. From February 15 to May 15, Arizonans will be able to shop for affordable, comprehensive health insurance coverage at healthcare.gov.

The Affordable Care Act Marketplace (or “exchange”) serves as a critical source of health coverage for Arizona families. In 2020, over 153,000 Arizonans enrolled in health care through the Marketplace.

This special enrollment period marks a significant shift in ideology and a step in the right direction for child and family health. The Trump administration slashed funding for health insurance outreach, enrollment, and education, cut premium subsidies and funding for marketing, shortened the open enrollment period, and made it easier for companies to offer non-ACA compliant health plans.

In contrast, the Biden administration has announced plans to spend $50 million on marketing during the special enrollment period. The President has also instructed his agencies to revisit and work to rescind measures that inhibit enrollment in health coverage, such as Medicaid work requirements and the public charge rule. While these changes can’t happen overnight, the wheels have been set in motion.

The ACA Marketplace is always open for those who meet certain criteria (for example, people who become pregnant, move, or lose health coverage from another source). Outside of these special circumstances, people can only select or change their plan during the regular open enrollment period from November 1 to December 15. Medicaid and CHIP enrollment is open year-round for those who meet eligibility requirements.

Families and individuals who need help applying for coverage don’t have to do it alone. Health care assistors statewide can help Arizonans find the best source of health coverage for them and can help with completing applications for coverage through the Marketplace, AHCCCS, KidsCare, and more. CAA is proud to support CoverAZ, a service that helps people find an assistor near them. Interested parties can book an appointment online at coveraz.org/connector. CoverAZ also operates a phone line staffed by bilingual community health workers, who can help book a personalized appointment with an enrollment assister. Appointments are available by phone or in person.

State of the State

This week, the Arizona legislature begins its work for the year at a time when many Arizona children and families are struggling to meet their basic needs during this health and economic crisis. Recently released data by the U.S. Census Bureau shows 1 in 6 Arizona households with children (16%) said they had only slight confidence or no confidence at all that they would be able to make their next rent or mortgage payment on time. Increasing numbers of Arizona households with children are also reporting they do not have health insurance and/or do not have enough food to eat, and communities of color are disproportionately suffering.

That is why it will be so critical for lawmakers to focus their work on helping families achieve financial stability, and keeping children healthy and safe during these difficult times.

Our 2021 legislative priorities include:

  • Making health care more accessible for Arizona’s children by expanding eligibility for KidsCare, Arizona’s Children’s Health Insurance Program;
  • Restoring supports to grandparents and other kinship caregivers who step in and prevent children from entering foster care when parents are unable to care for their children;
  • Provide safe, quality child care options for working parents of young children by increasing the child care subsidy reimbursement rates;
  • Providing Arizona’s public schools with the same amount of funding for conducting virtual schools during the pandemic as they receive for in-person instruction.

What Arizona does not need is more tax cuts which will only reduce state revenues that struggling Arizona families are counting on to provide housing and food supports, and make child care more affordable. Rather than shortsighted tax cuts, we urge Governor Ducey and lawmakers to take a more responsible approach and prioritize a plan to stop the uncontrolled spread of COVID-19, and put Arizona on a path to recovery from this health and economic crisis.

Read our 2021 Legislative Priorities

Today’s the day – ACA repeal oral arguments before SCOTUS

Oral arguments in the case challenging the constitutionality of the Affordable Care Act (ACA), now named California v. Texas, are being heard today at the US Supreme Court. If part or all of the ACA is overturned, the only way to save the law, and all the protections for Americans that come with it, would be through congressional action. This is considered highly unlikely if the US Senate remains under Republican leadership.

The Urban Institute recently projected that more than 21 million non-elderly Americans will be newly uninsured in 2022, including 1.7 million children, if the ACA is overturned. Those most at risk of losing coverage are people with incomes below 200% of the federal poverty level and people of color. In Arizona alone, the Urban Institute estimates that 223,000 non-elderly individuals are likely to become uninsured if the ACA is repealed.

The ACA led to tremendous gains in the rate of children’s health coverage in Arizona. As CAA’s most recent KIDS COUNT Data Book demonstrates, the rate of uninsured children in our state dropped from 13% in 2012 to 8% in 2018 (per data from the United States Census). Unfortunately, Arizona has seen a reversal of this trend since the Trump administration took office. While funding for outreach and enrollment support has been cut, anti-immigrant rhetoric and policies, such as the new public charge rule, has deterred many families from enrolling in health care. As a result, kids are losing the coverage they need to grow up healthy and succeed in life.

Until we have a ruling from the Supreme Court, which likely won’t happen before next spring, the ACA remains the law of the land. The annual open enrollment period began November 1 and will continue through December 15. The ACA Marketplace, Medicaid expansion, and KidsCare continue to cover tens of thousands of Arizona children and families. And, all Arizonans are able to get quality health insurance that covers essential benefits like doctor visits, prescriptions, hospital services, and more.

CAA is a proud partner of CoverAZ. CoverAZ’s network of promotores and community health workers can help you find the best health care option for your family. To schedule an appointment, visit coveraz.org/connector or call 1-800-377-3536.

*Enrollment in AHCCCS and KidsCare is always open. A CoverAZ assistor can help you figure out if you qualify for these programs, too!

KIDS COUNT Data Book is the only source to focus on statewide trends about Arizona’s children

Children’s Action Alliance (CAA) is proud to present the 2020 Arizona KIDS COUNT Data Book—the only biennial source to focus on statewide trends about Arizona’s children. Thanks to the support of the Annie E. Casey Foundation, this powerful resource helps inform decision-makers and stakeholders about the economic, social, and physical well-being of children and their families throughout the state. In addition to the Data Book, statewide and county indicators can be found on our new and updated website – along with other resources, toolkits, and information on how to advocate for children and families.

As you know, CAA regularly uses data as a compelling tool to find common ground across geography and political ideology to create an Arizona where every child is safe, loved, and has access to quality education and affordable health care. In this KIDS COUNT Data Book, the data show Arizona has made important strides in improving the conditions for children since the Great Recession - before the unprecedented challenges our communities, our state and our nation have faced due to the COVID-19 health crisis.

The 2020 Arizona KIDS COUNT Data Book offers a closer look at the strengths and contributions of immigrant families as more than 1 in 4 children are growing up in an immigrant household and 6 in 10 Arizona children are children of color.  Despite the changing demographics in the state, children of color are more likely than their White peers to lack the fundamental supports to grow up healthy and strong. It is our hope that YOU - lawmakers, advocates, and state agency leaders use the information in this Data Book to address the long-standing structural inequities in our state. It is time to move towards an Arizona that provides opportunity for all children, not a privileged few.

As advocates for children, we will continue to challenge ourselves to think creatively and critically to find new ways to support Arizona’s children and families. Join us and use the Data Book and other resources on our new website to spark action for measurable and positive change.

New Developments in the ACA repeal case before SCOTUS

The Supreme Court of the United States has set a date to hear oral arguments in California v. Texas: one week after election day, November 10, 2020. This lawsuit has the potential to overturn the Patient Protection and Affordable Care Act (ACA), which has been instrumental in providing comprehensive, quality health coverage to children across the country.

The lawsuit, known in the lower courts as Texas v. Azar and Texas v. US, was brought forth by Texas and 19 other states. They allege ACA is no longer valid because the 2017 Tax Cuts and Jobs Act set the tax penalty for not having health insurance to $0. Among those seeking to repeal the Affordable Care Act is Arizona’s Attorney General Mark Brnovich. Attorney General Brnovich and opponents of the ACA argue that a patchwork of state-level laws will protect patients in the same way. But, this is misleading.

For example, this year in Arizona, State Senator J.D. Mesnard passed legislation that purportedly provides protection against discrimination for people with pre-existing conditions. However, the law does not explicitly protect against price gouging for these individuals, and our state is woefully underprepared to enforce the law. The Arizona Department of Insurance and Financial Institutions, which investigates complaints against insurance companies, has just six investigators who oversee 1,600 insurers. Of the more than 3,000 complaints filed with the agency in FY2019, only 345 were investigated.

Children’s Action Alliance recently partnered with researchers at ASU’s College of Health Solutions to examine the impact of ACA repeal on Arizona’s children and families. The report examines key tenets of the ACA, including its protections for people with pre-existing conditions, Medicaid expansion, and its tremendous impact on reducing the rate of uninsured children in Arizona.

To read the full report, click here.

Governor Ducey’s Plan to Fight the Flu during COVID-19

Yesterday, Governor Ducey and the Arizona Department of Health Services announced a comprehensive vaccine distribution plan to curb the spread of the flu this fall and winter. Children’s Action Alliance applauds the Governor’s effort to provide this lifesaving vaccine to everyone, regardless of immigration status or income. The COVID-19 pandemic has placed an unprecedented strain on Arizona’s hospital and health care systems. A major flu outbreak could force the health care system to fight a war on two fronts.

Influenza is one of the top ten leading causes of death in Arizona. Each year, an average of 700 people die due to the flu in our state, and young children and American Indian / Alaska Native individuals are at a particularly high risk of complications from the virus.

The Governor is taking a data-driven, multi-pronged approach to promote public health and preserve precious health care resources:

  1. Significantly expanding the number of flu shots available to uninsured and under-insured people in Arizona, including undocumented immigrants;
  2. Incentivizing AHCCCS and KidsCare participants to get the flu shot by offering a $10 gift card to all members who get vaccinated;
  3. Increasing payments to AHCCCS and KidsCare-contracted providers who administer flu shots;
  4. Allowing certified pharmacists to provide vaccines to children who participate in AHCCCS and KidsCare;
  5. Expanding flu shot distribution to certain COVID-19 testing sites throughout the state, and;
  6. Providing online resources for health care providers, businesses, and families to help them locate no-cost testing and take proactive steps to protect employees.

According to the Governor, the use of incentives to patients and providers and expanding availability of flu vaccines has shown a 50 percent increase in vaccine rates among Medicaid members in other states. We commend this proactive investment in community health and encourage everyone to get a flu shot as soon as you are able!

Additional flu-related resources will be available soon at azhealth.gov.