Needy Arizona children to lose health care, medicine coverage

Alia Beard Rau -
Mar. 20, 2010 12:00 AM
The Arizona Republic .

This summer, Arizona will become the only state in the nation that doesn't provide health-care coverage under a federal program to insure children of the working poor.

State lawmakers last week eliminated Kids- Care, which serves nearly 39,000 children through age 18, through budget-balancing measures. The program cost the state $18 million a year, and federal funds covered $56 million.

The program will end June 15.

KidsCare advocates say the program's demise will have long-term implications: Some children will no longer have access to preventive care, which could lead to more severe illnesses. Emergency rooms will see more uninsured children. Other residents will pay higher insurance premiums to cover the rising costs of the uninsured.

Lawmakers who supported the budget cuts say they had no other choice.

"Under the circumstances, this is the best we can do," said Rep. John Kavanagh, R-Fountain Hills. "Over the last decade, we grew government at a ridiculously fast pace. This is unavoidable action."

KidsCare was created in 1998 as part of the Children's Health Insurance Program, a national effort to decrease the number of children without health care. Despite opposition from a handful of conservative Republicans who argued that it was "socialized medicine," the program was overwhelmingly supported by most legislators and strongly backed by then-Gov. Jane Hull.

The federal grant program offers states a match of 75 percent federal money to 25 percent state money to either expand their Medicaid program or develop a separate program to serve children in families that earn too much money to qualify for Medicaid. All 50 states participate.

Other states, including California, have considered eliminating their programs. None have yet done so.

KidsCare serves children who aren't covered by the Arizona Health Care Cost Containment System, the state's Medicaid program. For example, the child of a single parent could qualify for AHCCCS if the parent makes less than $14,570 a year before taxes, or could qualify for KidsCare if the parent made $14,570 to $29,140.

"These are working families," said Monica Coury, an AHCCCS spokeswoman. "They just don't have access to private, commercial insurance either because they can't afford it or because they don't have it at their workplace."

KidsCare participants pay a fee of $10 to $70 a month, depending on income. The program covers doctor visits, immunizations, prescriptions, surgery, emergency-room visits, vision and dental care. Children cannot be excluded for having a pre-existing condition.

Gaites Klein, 13, of Phoenix, is one of the children who will lose services when KidsCare shuts down. The eighth-grader had a brain tumor removed about a year ago and must take daily medication.

"If I did not have that program, I would not be talking to you right now," he said. "I would die."

Gaites, who has recovered from brain surgery and is back to sports, computer games, piano practice and yo-yo lessons, said he feels like a KidsCare success story. But he said he is scared of what will happen to other kids when the program ends.

"I challenge politicians to take one day out of their busy, busy lives trying to push bills that hurt people and go up to the pediatric intensive-care unit and sit with the parents, the kids and the doctors," he said. "See all that goes on and tell me these kids should not be saved."

Gaites' mother, Valarie, has been out of work for nearly two years since the mortgage-refinance company she worked for went out of business. But between her unemployment and the child support from Gaites' father, the family has too much income for Gaites to qualify for AHCCCS.

She said she has been going to interviews and hopes to get a job - and health insurance - soon. But even then, she is afraid her son could be excluded from coverage because of his pre-existing condition. She said she doesn't know where she'll find the money for the annual MRIs and more than $200 a month in medication her son needs.

"When I first found out the news that they voted to cut KidsCare, I cried," she said. "And I'm not just crying for my son. I'm crying for the children that will not get the medical care they need and deserve."

Matt Jewett, director of health policy for the Phoenix-based advocacy group Children's Action Alliance, said there are some alternatives to KidsCare, "but none are as good."

"This is a program that is inexpensive for the state, and there is not gong to be anything similar to it," he said.

He said he is directing families to their local community health centers, such as the non-profit Mountain Park Health Center, which has locations in Phoenix, Tempe and Tolleson. He also suggested the non-profit HealthCare Connect, which charges an annual fee to Maricopa County residents for access to medical services at a discounted cost.

Coury said KidsCare participants will be sent a letter notifying them of the program's demise and explaining some of their options, including those that Jewett mentioned.

But Jewett said even with that information, many families will go without primary care. They'll wait until there is an emergency, he said, and go directly to a hospital emergency room where they have to be seen regardless of their insurance situation.

"That means more losses for the hospitals, which have to make up that loss by charging everyone else a higher cost, which leads to higher insurance premiums and more employers dropping health insurance," he said.

John Rivers, CEO of the Arizona Hospital and Healthcare Association, said the hospitals believe that's exactly what will happen.

"I understand the fiscal pressures under which the state Legislature is operating, but the short-term financial benefit to Arizona will greatly be outweighed by the long-term harm to virtually everyone in the state," he said. "There's just no benefit to these children, no benefit to other citizens in Arizona who are wanting to keep their health-insurance premiums low and no benefit to Arizonans who want to be able to enjoy maximum access to our emergency rooms when they need it."

He said his organization is considering an effort to take the issue to the voters in the fall and get the program reinstated.

"Kids are very inexpensive to insure, inexpensive to care for and keeping them healthy is a great investment in our future," he said.

Dr. Jane Orient, a Tucson internist and leader of the advocacy group Association of American Physicians and Surgeons, said Arizona already invests in health care for needy children through AHCCCS. She has opposed KidsCare since its inception, arguing that parents in the income range it covers can afford their own insurance.

"I didn't see any reason for it," she said.

Orient disagrees with concerns that eliminating the program will fill emergency rooms and raise insurance costs.

"I think most doctors are willing to take care of someone who is truly needy," she said.

But even if the decision does leave some Arizona children without health-care coverage, Orient said, there is no alternative in the state's current financial situation
. "At a certain point, it doesn't matter how good you think a program is," she said. "If you can't pay for it, what are you going to do?"

Republic reporter Mary Jo Pitzl contributed to this article.

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