In my five decades of providing medical care to Arizona children, I have realized that Medicaid (AHCCCS) and KidsCare (Arizona’s version of a Children’s Health Insurance Program, known as CHIP) are critical for low-income families. KidsCare has been frozen since 2010, and the Legislature now has the opportunity to include lifting the freeze in their budget negotiations, while the federal government picks up the tab.
KidsCare protects families affected by a flaw in the Affordable Care Act, called the family glitch, where dependents of an employee might not qualify for tax credits to offset the costs of health coverage. Additionally, KidsCare isn’t a handout: Children on KidsCare come from hard working families that work and pay monthly premiums and copays that help fund KidsCare.
Studies clearly show that without health coverage, such as KidsCare, low-income children are disproportionately affected, since paying the rent, food, utilities and transportation does not leave enough money to purchase medical insurance and cover the cost of deductibles, some of which can be $5,000 to $10,000 or more.
A recent article in the Harvard Business Review confirms the importance of CHIP for families, concluding that parents who do not have to worry about health coverage for their children are more likely to start a business on their own. Entrepreneurial spirit is good for the economy at both the national and local level. Because Arizona is the only state without a CHIP, we the taxpayers of this state are subsidizing the other 49 states that do have one. Arizona ranks third highest in percentage of uninsured kids, which means sicker children in classrooms and day care centers statewide and, consequently, more worried parents.
These children, if not on KidsCare, are at least twice as likely to use the emergency room (ER) for non-urgent care. It costs on average $68 for children to see their primary care providers in their offices and $275 in the ER. ERs are mandated by federal law to see all patients that are US citizens, regardless of ability to pay. As a result, hospitals end up writing off most or all the charges, which are in turn, passed on to consumers. Recent studies have shown that uninsured children are four times more likely to use the ER for non-traumatic medical care, compared to children who do have CHIP coverage. This unnecessarily adds to longer times in waiting rooms for all patients, when minor ailments, such as ear infections or sore throats, can be easily treated in a doctor’s office.
It is my medical recommendation that Governor Ducey and our legislators propose lifting the freeze on KidsCare during their budget talks. It is the smart thing politically, educationally, medically, economically, and financially, but most importantly, it is the right thing for Arizona and for the children in our state.
A.D. Jacobson, M.D., is a professor of Pediatrics at the University of Arizona Medical School in Phoenix; past chief of ambulatory pediatrics at Phoenix Children’s Hospital; past medical director of the Phoenix Children’s Care Network; and an original founder of Phoenix Children’s Care Network