KidsCare Expansion

The Arizona Health Care Cost Containment System (AHCCCS) is requesting an amendment to the State’s current Demonstration project, “Arizona Medicaid Section 1115 Demonstration” under section 1115 of the Social Security Act (Project Number 11-W-00275/9), to seek authority to raise the Children’s Health Insurance Program (CHIP) eligibility thresholds from 200% of the federal poverty level (FPL) to 225% FPL. This separate CHIP program authorized under Title XXI of the Social Security Act, is also known in Arizona as “KidsCare.”

This request is in alignment with Arizona Senate Bill (SB) 1726 which, subject to CMS approval, provided state authority to expand Kidscare eligibility to include members with income at or below 225% of the FPL. Prior to submitting this 1115 Waiver Amendment Request, AHCCCS sought CMS approval to expand KidsCare (CHIP) financial eligibility through a State Plan Amendment (SPA). However, CMS informed AHCCCS that the State had maxed out its eligibility levels using Title XXI funds under regulatory parameters for CHIP coverage expansions established at Section 2110(b)(1)(B)(ii)(II) of the Social Security Act and 42 CFR 457.310(b)(1)(iii)(A).

This 1115 Waiver Amendment will advance the following strategic objectives of the KidsCare Program:

• Reduce the number of uninsured children,
• Maintain or increase annual dental visits,
• Maintain or increase child and adolescent well-care visits, and
• Maintain or increase metabolic monitoring for children and adolescents on antipsychotics.