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Arizona experts urge simpler Medicaid/CHIP transitions as thousands could gain KidsCare
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Summary
A web briefing of the Arizona Advisory Committee to the U.S. Commission on Civil Rights heard that administrative redeterminations and enrollment complexity are driving children off coverage and that raising KidsCare eligibility to 225% of the federal poverty level on Nov. 1 will add an estimated 12,000 children.
At a Sept. 29 web briefing, Matt Jewett, director of health policy at Children's Action Alliance, told the Arizona Advisory Committee to the U.S. Commission on Civil Rights that administrative hurdles and program complexity are a major driver of children losing health coverage in Arizona.
Jewett said the state’s traditional Medicaid program (ACCESS) and the state's CHIP program (KidsCare) have reduced the child uninsured rate but that American Indian and Alaska Native children remain about "2 and a half times" as likely to be uninsured as other groups in the state. He explained that continuous enrollment protections during the COVID-19 public health emergency reduced churn, and that resumption of routine redeterminations has produced disenrollments—often for procedural reasons when families do not return prepopulated renewal forms.
"Insurance does not always mean access to care," Jewett said, noting that not every provider accepts every form of coverage. He described tools Arizona uses to reduce paperwork—data hubs that verify income from tax records and a statewide network of more than 200 community organizations that help families enroll—but said gaps remain in outreach and in getting families to complete renewals.
Jewett detailed a near-term policy change: as a result of the state budget, KidsCare eligibility will rise to 225 percent of the federal poverty level on Nov. 1, which he said "should mean an additional 12,000 children in Arizona will have access to low cost health insurance through KidsCare" and brought the family-of-four income limit to about $67,500. He added that participation remains imperfect and that outreach and assistance are needed so newly eligible children gain coverage.
Committee members asked about whether disenrollments are primarily procedural. Jewett said many disenrollments are for procedural reasons—mail and renewal barriers in tribal and rural communities and limited community assisters—and urged simpler interfaces between Medicaid and the federal marketplace so eligible families are not lost during transitions. He also stressed that younger children are more likely to get routine well-child care and that teens and young adults have higher uninsured rates.
The committee did not vote on a formal recommendation during the briefing. Members asked staff to collect additional materials Jewett offered to provide for the record. The committee plans further briefings and public outreach to inform any recommendations to the Commission.
