Arizona has become the first state to cancel its State Children's Health Insurance Program, which, like other SCHIP programs, is funded jointly by the state and the federal government.
The budget passed by the legislature and signed into law by Republican governor Janice K. Brewer eliminates the $22.9-million program, known as KidsCare, as of June 15th. The program served 38,000 children living in families with incomes between 100% and 200% of the federal poverty level ($22,000 to $44,000 for a family of four).
A statement on the Web site of the Arizona Health Care Cost Containment System, the state's Medicaid agency, said simply, "The State does not have enough funds to keep paying its portion of this program."
Brewer proposed cutting the program in her "State of the State" address in January. "As an Arizonan, as a mother, and as a person who feels great compassion for the vulnerable and less fortunate," she said, "it is only with great reluctance that I advocate a number of deep reductions in funding. . . . As governor, I have a duty to preserve State government's fiscal integrity and to ensure Arizona's long-term health."
The state faced a projected shortfall of $2.6 billion in fiscal 2011.
Arizona pediatricians were furious about the program's cancellation. "Our elected officials have said the budget deficit left them with no choice but to eliminate this coverage, but they did have a choice and they chose to put our children's health at risk, deny them access to a medical home and critical preventive health services," Mary Rimsza, MD, chair of legislative affairs for the Arizona chapter of the American Academy of Pediatrics, said in a statement. "This decision will increase healthcare costs by cost-shifting, overuse of emergency rooms, and lack of early intervention." Roland Goertz, MD, president-elect of the American Academy of Family Physicians, also said he was upset about the program's cancellation. "It's a sad situation when you have to cut care for children," said Goertz, who practices in Waco, Texas. "I don't know that there's any way possible for it not to impact the health of the children that are going to be [no longer covered]."
Some Arizona physicians may have to turn away children who become uninsured as a result of losing SCHIP coverage, he said. "The vast majority of physician practices are small businesses, and they have to make decisions based on whether the bottom line is met or not. . . . I think it's going to happen because I don't know a way it can't happen."
Goertz said he hoped other states would not follow in Arizona's path. Because of the recession, "fiscal crises are unfortunately more common, but I hope they don't go to the extreme that Arizona has gone to."
Jenny Sullivan, senior health policy analyst at Families USA, said that there are several good reasons why states might not be inclined to completely eliminate their SCHIP programs. "Number one, it's not popular to cut coverage for kids, so there's a political price."
But more importantly, she said, "from a financial perspective, it doesn't save the state very much money," because states only provide 35% of the funds for the program, and the rest comes
from the federal government. "States without a doubt are in historic budget crises, but cutting SCHIP is not necessarily the best way to save state funds."
Sullivan said she was hopeful that some stimulus programs that are giving states additional healthcare funds will be extended. "That will give states extra money for Medicaid, which will help them with the general fund and give them more money for other things like SCHIP," she said.
Sullivan also raised another possibility: the Senate version of the healthcare reform bill, which is scheduled for a vote in the House on Sunday, contains a "maintenance of effort" provision requiring states to maintain any children's health programs that are in existence when the bill is passed. In that situation, Arizona would not be permitted to discontinue its SCHIP program, she said.
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Sullivan also raised another possibility: the Senate version of the healthcare reform bill, which is scheduled for a vote in the House on Sunday, contains a "maintenance of effort" provision requiring states to maintain any children's health programs that are in existence when the bill is passed. In that situation, Arizona would not be permitted to discontinue its SCHIP program, she said.
Is anybody here who has taken on the responsibility of taking care of themselves, their family, and yes their own children starting to feel a little uneasy about what is about to happen to their wages.
The federal government has just assumed possession of a bigger chunk of what people earn. This will continue until the dignity of taking care of yourself has been completely stolen, and that is precisely why liberalism, socialism, communism, state ism...whatever you want to call it, is so cruel.
This all has nothing whatsoever to do with health care folks.
C. Davis
__________________ Am I greedy because I don't want to give you what is mine?
or
Are you greedy because you want to take what is not yours?
Is anybody here who has taken on the responsibility of taking care of themselves, their family, and yes their own children starting to feel a little uneasy about what is about to happen to their wages.
Yes and I am from Arizona.
Tax revolt. I hope one comes soon. About 2 million people not paying their taxes is all it would take.
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Arizona Cancels SCHIP Program for Lack of Funds
