Assigned to HEA                                                                                     FOR CAUCUS & FLOOR ACTION

 

 


 

ARIZONA STATE SENATE

Phoenix, Arizona

 

REVISED

FACT SHEET FOR S.B. 1074

 

children’s health insurance; requirements; study

 

Purpose

 

Replaces the six-month waiting period for eligibility for the children’s health insurance program (CHIP) with the authority of the Director of Arizona Health Care Cost Containment System (AHCCCS) to prescribe rules for a waiting period.

 

Background

 

In 1998 the Legislature established CHIP to provide health care coverage to children under age 19 from families with income up to 200 percent of the federal poverty level ($34,100 for a family of four). As of January 1, 2001, 94,573 children have been approved for health care coverage due to the outreach activities of the AHCCCS administration and other organizations; 42,875 have been enrolled in CHIP and 51,698 have been approved for Medicaid.

 

Federal law requires each state’s CHIP plan to include a description of the state’s procedure that ensures coverage under CHIP does not substitute for health insurance coverage under private group health plans.  To address this requirement, many states implemented “crowd out” policies or eligibility waiting periods to discourage parents and employers from dropping current coverage for the purpose of enrolling children into CHIP.

 

A.R.S. §36-2983 imposes a six-month eligibility waiting period for children with previous coverage unless that coverage was discontinued due to loss of employment or another involuntary reason.  S.B. 1074 eliminates this waiting period and allows the Director of AHCCCS to adopt rules that impose a waiting period for a child who voluntarily drops health insurance coverage.

 

Each month, an average of 117 children are denied eligibility for CHIP due to private health insurance coverage.  According to AHCCCS, the cost of providing coverage to these children for one year is approximately $135,000.  Of this amount, 25 percent or $33,750 represents the state’s matching funds.  However, this figure does not include enrollment growth or a change in behavior for families who have private health insurance coverage.

 

Provisions

 

1.      Eliminates the required six-month waiting period for eligibility when a child’s health insurance coverage is voluntarily dropped.

 

2.      Allows the director of AHCCCS to adopt rules that require a time period during which a child who voluntarily discontinues insurance coverage must remain uninsured.

3.      Makes a conforming change.

 

4.      Provides for a general effective date.

 

Amendments Adopted by Committee

 

Applies the crowd-out provision to children who voluntarily discontinue previous health insurance, rather than those who are involuntarily dropped.

 

Senate Action

 

HEA                1/23/01            DPA    7-0-1-0

 

 

Prepared by Senate Staff

January 30, 2001