Arizona Eagletarian

Arizona Eagletarian

Tuesday, August 14, 2012

Arizona: Kids Care enrollment opens for short time UPDATED 8/17/12

Moments ago, I received the following press release from the Arizona House of Representatives:

Limited enrollment for KidsCare II now open
Quezada: ‘Parents need program information so they can act now’
STATE CAPITOL, PHOENIX – Enrollment in KidsCare II, Arizona’s temporary Children’s Health Insurance Program, is open for a limited time. Rep. Martin Quezada, D-Avondale (District 13), is working to keep Arizona parents informed about the options that currently are available.
“Enrollment for KidsCare II is only going to be open for a short time. There are a limited number of spots available for this children’s health care program. The enrollment guidelines have changed and parents need program information so they can act now,” Quezada said. “Arizona remains the only state in the country that has not fully restored funding to KidsCare. KidsCare II is a short-term solution but until Republicans can agree to fully fund KidsCare, an investment of about $7 million, thousands of Arizona children will remain without health care coverage. We must set aside partisan bickering to find a long-term solution to this issue.”
About 25,000 children will be able to enroll in KidsCare II, and those slots are being filled on a first come, first serve basis. To be eligible for KidsCare II, a child must:
· Be an Arizona resident
· Be 18 years old or younger
· Be a citizen of the United States or a qualified immigrant
· Have a Social Security number or apply for one
· Be under the income limit
· Not be currently covered by other health insurance
· Not be qualified for coverage through a state agency employee
· Not be eligible to receive AHCCCS (Medicaid) coverage
· Be a member of a household that is willing to pay a premium
For more information about the program, including income limits, or to apply go to or call 1-800-235-9678.

That's the good news. I'm looking into how and why this limited enrollment has temporarily opened up. When I receive that information, I will update this post (probably tomorrow). Kids Care is funded heavily by the federal government (authorized by Congress), with lower matching requirements than most federally funded grant programs.

In the meantime, it appears that Governor Brewer and some of her top advisors may get involved in trying to encourage state lawmakers to approve accepting the expanded Medicaid provisions of the federal Patient Protection and Affordable Care Act. The timing of that news can put pressure on some GOP primary races (for the state legislature).



While unable to get a response from anyone at AHCCCS (the agency administering Kids Care), I did receive the following from Murphy Hebert, Public Information Officer for the Arizona House Democrats:

Please be advised that CMS approved the AHCCCS 1115 Demonstration Waiver Amendment request.
By way of background, this demonstration waiver request was first submitted as part of the Governor's Medicaid reform package last year. It allows the state to utilize local government funds to leverage federal dollars to provide uncompensated care. CMS originally denied this request because they did not feel that dedicating new resources to an uncompensated care pool in the context of a demonstration that otherwise reduces coverage was consistent with their objectives. This essentially meant that they would not allow the state to significantly cut its Medicaid population but then give more federal dollars to make up for the loss. However, CMS indicated that this request could be accommodated if the plan included a proposal to reenroll more individuals under Medicaid. The Governor then partnered with UA Health Network, Maricopa Integrated Health Systems, and Phoenix Children's Hospital and submitted a proposal to provide uncompensated care, hospital improvements, and expand KidsCare, and the revised request was granted late last week.
In addition to the Safety Net Care Pool, the Demonstration Waiver approves the utilization of Prop 202 gaming funds as matching dollars, which will provide an additional $13M for funding for rural hospitals, trauma hospitals and emergency departments statewide. Finally, it provides additional federal funding to offset uncompensated care in Indian Health Services and tribal 638 health facilities.
I have attached the CMS approval letter. Please let me know if you have any questions or concerns.

Unfortunately, this language was apparently first sent in an email by someone at AHCCCS or the governor's office in April. So, while it does provide some background insight on how and why this limited enrollment is now available, it also raises other questions. Like, why now?

This announcement conveniently coincides with news reported on Monday by the Arizona Republic:

Two key advisers to Gov. Jan Brewer are attempting to create a coalition of hospitals, insurance plans, providers and other players to push Arizona to expand Medicaid under federal health-care reform.
Last week, the board of a statewide group of human-services providers agreed to hire Chuck Coughlin and Peter Burns, and the state's largest hospitals and health plans are considering signing on.
The pair would bring political and technical savvy to the complex realm of health care, with the goal of marshaling a united front of heavy-hitting businesses to push Medicaid expansion through the Legislature next session.
Remember the defiant rhetoric by red state governors in the wake of the Supreme Court ruling that Obamacare will stand? The salient question in those first days after the ruling was whether a given state would participate in provisions to expand Medicaid.

In June, the U.S. Supreme Court largely upheld the federal Affordable Care Act, including a requirement for almost everyone to obtain health insurance. However, the court also ruled that states could reject the law's Medicaid expansion without being penalized.
Six Republican governors have opted out so far, but Brewer has said she wants to hear from Arizona stakeholders and get more information about federal requirements and the potential impact before making her decision.
Medicaid is a state-federal program for low-income and disabled people. Federal funds would cover most of the cost of expanding the program.
The governor's staff said last week that Brewer's decision will be part of her budget proposal for fiscal 2014, which she'll release in early January.
But Burns and Coughlin aren't waiting. Their idea is to bring together those with a stake in Medicaid expansion to show Brewer they are behind her and to provide the financial data and other background information to support Medicaid expansion.
While the Republic, in a news story, cannot speculate on who knows what information and must go with what information it is given, I am not so bound. In my mind, there is little no doubt the Brewer's already been -- at minimum -- briefed on Coughlin and Burns' plan. She's probably a "co-conspirator." Of course, there's nothing illegal about having advisors work with stakeholders. The only reason I can think of for this apparently clandestine effort to strong arm tea party incumbents and candidates for GOP seats in the legislature is because Brewer really does want to participate in the Medicaid expansion.

She's been (rightfully) vilified for cutting AHCCCS enrollment despite voters having mandated otherwise (Prop 204 in 2000).


According to AHCCCS legislative liaison Jennifer Carusetta, the agency first (after the waiver was approved in April) reached out to families of the approximately 100,000 children on a wait list. That list was established when Kids Care enrollment cut off due to elimination of state funding from the legislature.

Carusetta indicated that 13,000 children from that wait list have now enrolled. The remaining families on the wait list are still welcome to enroll, but because community funding has been secured for the required match to federal funds, the program can be opened for those who had not tried earlier.  The federal government, she said, provides $3 for every $1 state or local funding is provided. That's a 75/25 ratio.

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