Assigned to HEA                                                                                                                         FOR COMMITTEE

 

 


 

ARIZONA STATE SENATE

Phoenix, Arizona

 

FACT SHEET FOR S.B. 1075

 

children’s health insurance; hardship exceptions

 

Purpose

 

Requires the Director of the Department of Arizona Health Care Cost Containment System (AHCCCS) to adopt rules to grant a hardship exemption to families who are not able to pay the premiums for the children’s health insurance program (CHIP). 

 

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 (currently $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.

 

Pursuant to A.R.S. §36-2982, the administration is required to adopt rules for disenrolling a child for nonpayment of premiums.  Under AHCCCS rules, a child’s coverage is terminated for failure to pay premiums in two consecutive months.  A child who is terminated for nonpayment of premiums may be re-eligible when full payment is made.  For households at or below 150 percent of the federal poverty level (FPL), there are no premiums.  For households with income over 150 percent FPL but less than 175 percent FPL, the monthly premium payment is $10 for one child and $15 for two or more.  For a household with income over 175 percent FPL up to 200 percent FPL, the monthly premium is $15 for one child and $20 for two or more.

 

Between December 1999 and January 2001, a total of 4,856 children were terminated for the nonpayment of premiums for two months.  The bad debt amount associated with these members is approximately $80,000; the state’s share of which is 25 percent or $20,000.  S.B. 1075 attempts to provide continued health care coverage to hardship cases by requiring the AHCCCS Director to prescribe circumstances to grant a hardship exemption to the disenrollment requirements for families who cannot pay the premiums.

 

Provisions

 

1.      Requires the AHCCCS Director to prescribe the circumstances to grant a hardship exemption to the disenrollment requirements for a member who is not able to pay the premiums under CHIP.

 

2.      Makes technical changes.

 


3.      Provides for a general effective date.

 

 

Prepared by Senate Staff

January 19, 2001