Arizona Child Health Insurance Rates Third Worst in the Nation

Arizona Child Health Insurance Rates Third Worst in the Nation
Bill Kuschel / Creative Commons

The percentage of Arizona children who don’t have health insurance is shrinking, but, for the fifth year in a row, the state remains among the worst in the nation for access to care, according to a new report from Georgetown University.

Ten percent of Arizona children were uninsured in 2014, which is nearly 2 percent less than 2013, reported Joan Alker and Alisa Chester, of Georgetown’s Center For Children  and Families. At the same time, the national average dropped from 7.1 percent to a historic low of 6 percent. 

Alker and Chester gave credit for the significant improvements to President Barak Obama’s Affordable Care Act, which went into effect in January of 2014, even though most of its provisions didn’t target children. In particular, the researchers found, states that embraced the act’s expanded Medicaid coverage for adults, as Arizona did, saw nearly double the rate of decline in uninsured children as those that did not.

This is likely because, before the ACA’s passage, the majority of the country’s uninsured children already qualified for federally subsidized healthcare through Medicaid or the Children’s Health Insurance Program, known colloquially as CHIP, but had not been enrolled. So, when the government reached out to offer parents help, Alker and Chester wrote, it was like laying out a “welcome mat” for the children.

Children’s Uninsurance Rates by Medicaid Expansion Status, 2013 to 2014
Children’s Uninsurance Rates by Medicaid Expansion Status, 2013 to 2014

Arizona’s uninsured rate remains high, in part, because the state shut down its version of CHIP, called KidsCare, according to an earlier study by Georgetown’s Elisabeth Wright Burak. It is the only state in the nation that does not participate in CHIP, a fund-matching program designed to encourage states to protect children from families of modest means that earn too much money to qualify for Medicaid.

While the nation’s uninsured rate has steadily declined since 2008, Wright Burak wrote, Arizona’s has fluctuated up and down as the state froze enrollment in KidsCare in 2010, temporarily reopened the program under the name KidsCare II in 2012, and then ultimately shut it down in 2014.

Of the 37,000 Arizona children who were enrolled in KidsCare II in January of 2014, 23,000 were moved to Medicaid and 14,000 lost coverage, according to the report.

Some of these families may have received a subsidy under the ACA to purchase private health insurance. Others, however, probably fell victim to the ACA’s “family glitch,” Wright Burak wrote. If a parent is offered health insurance through his or her employment, the government assesses its affordability based on the price to cover an individual, not an entire family, leaving children at risk of being uninsured.

Percent of Uninsured Children: Arizona vs. United States, 2008-2013
Percent of Uninsured Children: Arizona vs. United States, 2008-2013

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