With no immediate congressional action in sight, state Medicaid officials are preparing to implement a contingency plan to ensure that nearly 24,000 children of Arizona working poor do not lose their health care coverage this coming month.
Heidi Capriotti, spokeswoman for the Arizona Health Care Cost Containment System, said Tuesday her agency will use money it gets from the federal government for the traditional Medicaid plan to pay the premiums for youngsters in the KidsCare program. She said that will mean no interruption in care even as the federal dollars that have funded the program dry up.
But Capriotti warned this is, at best, a short-term solution. She said there are only enough dollars in that Medicaid account to keep the KidsCare premiums paid into the first quarter of 2018.
And after that? Capriotti said if Congress does not come through by that point, it will be up to lawmakers to decide whether to find the dollars elsewhere — KidsCare is budgeted at more than $9.3 million a month — or simply kill the program and leave the children without health coverage.
The reason all this is an issue is the failure of Congress to reauthorize the Children’s Health Insurance Program.
It provides low-cost health insurance to children whose parents earn less than 200 percent of the federal poverty level, about $40,840 for a family of three. Premiums are no more than $50 a month for a single child and $70 for multiple children.
It is designed to aid families who earn too much to qualify for the regular Medicaid program, where income is limited to 138 percent of the federal poverty level, but who may not earn enough to purchase private insurance for their children or work for an employer that provides coverage.
The program has been around in some form since 1997. But Congress, distracted with debates over the future of the Affordable Care Act, did not meet the Oct. 1 deadline to provide the estimated $15 billion needed to care for the approximately 8.9 million children nationwide who are enrolled.
Efforts since then have become enmeshed with discussion of the total federal budget and tax cuts.
The House did approve an extension. But that has proven politically unacceptable to the Senate, which has yet to approve its own plan, because the House bill also includes cuts to some programs for the elderly.
In the interim, Arizona and other states have been able to use some federal CHIP dollars they did not use in the prior federal fiscal year. But Capriotti said that cash is running out.
Minnesota already has passed that point. The Pew Charitable Trust reports officials there are now using state funds to keep the program afloat.
Arizona’s short-term fix is a bit more complex.
Capriotti said the state currently has unused dollars in its regular Medicaid account. She said those can be applied to the KidsCare families, a move she said will be seamless.
She figures there’s enough cash available to keep KidsCare running “through the first quarter,” meaning the end of March.
How long this can go on may depend on enrollment.
An additional 600 children were signed up in just the past month. But the potential number of eligible children is much larger than that.
In 2010, there were 45,000 children signed up.
But that year, with the state unable to afford its share of the cost, lawmakers directed AHCCCS to freeze enrollment. Those already eligible were allowed to remain.
The result is that the number of children getting care dropped to a low of 528 by August 2016.
Last year the state lifted the freeze after Congress agreed to fund the entire cost of Arizona’s program. By the end of 2016 there were more than 9,700 children enrolled; the numbers have been increasing ever since.
Capriotti acknowledged that the state’s decision to use the Medicaid dollars is based on the assumption that Congress will, in fact, reauthorize CHIP — sooner or later.
“We plan to make up the balance once Congress reauthorizes the (KidsCare) funding,” she said.