Health care for more than 22,000 Arizona youngsters is in jeopardy because of congressional inaction.
The federal budget year expired Sept. 30 without lawmakers taking action to fund the Children’s Health Insurance Program for the new year. States use those dollars to provide care for about nine million children of the working poor, including 22,389 at last count in Arizona.
Congress’ failure to act on the $15 billion annual appropriation does not immediately leave these youngsters uninsured.
Heidi Capriotti, spokeswoman for the Arizona Health Care Cost Containment System, which administers the CHIP program, said officials from the U.S. Centers for Medicare and Medicaid Services say they have some unspent dollars from the fiscal year just ending. Capriotti said there should be enough to carry Arizona through October and November.
There is broad bipartisan support for the program. But the debate over how to fund it, coupled with the recent dysfunction of Congress, leaves the question of whether it can be restored – and how quickly – up in the air.
“We expect the Congress is going to take action soon,” Capriotti said, adding the debate on this health care program “kind of got derailed by Graham-Cassidy,” the last version of Republicans’ unsuccessful effort to repeal the Affordable Care Act.
But she conceded that may not happen.
“Obviously, we want to give our members 30 days’ notice prior to any program change,” Capriotti said.
There is another option: The state could pick up the tab.
But that is unlikely, given that the Republican-controlled Legislature balked last year at renewing the program even with no state dollars needed.
Arizona already provides health care for individuals and families up to 138 percent of the federal poverty level. That is $28,180 for a family of three.
CHIP, approved by Congress in 1997, is designed to cover the children in families who earn more than that but not enough to be able to afford private health insurance. Children can get covered if the family income is less than twice the federal poverty level, or $40,840, for that same family of three.
Arizona joined the federal program in 2001 under Gov. Jane Hull, a Republican. She said the federal match – three dollars for every state dollar – made it a good deal.
There have been bumps before in what is called the Kids Care program in Arizona, though not due to what is happening in Washington.
In 2010, lawmakers seeking to cut state spending said they could not afford even that 25 percent match. They imposed a freeze on enrollment, though those already in the program could remain as long as their families remained eligible.
The result was that the program, which had 45,000 children enrolled, dropped by last year to fewer than 1,000. It also left Arizona as the only state without a functioning program.
A divided Legislature last year agreed to reinstate the program after Congress agreed to pick up the full cost, at least through Sept. 30 of this year. It is that authorization – and more to the point, the funding – that is awaiting renewal.
But even with the state no longer having to provide a match, some Arizona legislators still opposed the program.
Andy Biggs, then the Senate president, said he wasn’t buying arguments that there would be no cost to the state. But if that were not the case, Arizona shouldn’t be lining up for the federal dollars, he said.
“While every program… has an advocate and a desire to accomplish a certain albeit potentially even altruistic or beneficent purpose, at some point one realizes that perhaps we can’t afford every program,” said Biggs, who at the time was running for Congress. He has since been elected.
And Sen. Nancy Barto, R-Phoenix, was unimpressed by arguments that Arizona has been the only state without a CHIP program.
“Well, kudos to us,” she said.
It actually took a bit of political gamesmanship to get the program restored over the opposition of GOP leadership and the lack of support from Gov. Doug Ducey.
Rep. Regina Cobb, R-Kingman, attached language to restart enrollment to Kids Care into legislation making changes in the program to allow more parents to use public dollars to send their children to private and parochial schools, something the Republican leaders wanted.
That gambit succeeded, as the House attached the amendment and approved the bill with 38 votes: 15 of the 36 Republicans joined with all 24 Democrats to override the GOP leaders.
Cobb, in pushing to restore Kids Care, conceded at the time that federal funding beyond Sept. 30 of this year was not assured. But she pointed out that if that happens, the measure contains language allowing the state to once again stop enrolling children, just as it did in 2010.