AHCCCS-covered diabetes education and KidsCare eligibility expansion bills pass House Appropriations Committee

Two more noteworthy bills were discussed, and ultimately passed, in the Arizona House Appropriations Committee meeting last week.

 

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House Bill (HB) 2083, introduced by Reps. Joanne Osborne (R – Goodyear), Jennifer Jermaine (D – Chandler), and Jennifer Pawlik (D – Chandler), would require the Arizona Health Care Cost Containment System (AHCCCS) to cover up to 10 hours per year of diabetes outpatient self-management training services for enrollees. This training would be covered if prescribed by a primary care practitioner and include personalized nutrition counseling, medication and testing education, and more.

The bill would also prohibit dollars from the hospital assessment fund from being used to provide diabetes outpatient self-management training services.

Chad Heinrich, representing the American Diabetes Association, testified in favor of the bill, stating that diabetes education services have been proven to lower medical costs for those that utilize them. He said including diabetes outpatient self-management training services in AHCCCS would not only result in better health outcomes for members in the system, but would result in about $2.3 to $2.7 million in state savings if approved into law. He added that, in 2019, AHCCCS paid about $869 million to treat diabetes.

Since Medicare and private insurance plans already cover these services, Heinrich said this would be an effort to close the coverage gap for individuals with Medicaid, under which these services were not previously covered.

Elva Hooker, a certified diabetes educator, also testified in support of the bill. She said this bill was important to empower individuals with diabetes to make healthy decisions for themselves in their everyday lives.

“It astonishes me to see individuals with high literacy and low literacy who come in and have no knowledge about how to take care of their diabetes, even if they’ve had diabetes for about 15 years. They may know to take medication, they may know to see their doctor, but beyond that, they have no power within themselves to be able to get positive health outcomes,” Hooker said.

She said adding diabetes outpatient self-management training services to AHCCCS-covered services not only supported better health outcomes for patients, but also led to a decreased economic burden on the patient, as they may have to take less medication than before.

“Our average patient comes in with an uncontrolled A1C of 9, which puts them at really high risk for complications, and after receiving our service of at least 10 hours of DSMT hours, they will leave our clinic with 7 A1C, which is good control, so they’re really reducing their risk for complications.”

Rep. Lorenzo Sierra (D – Avondale) voiced his support for what he said was both a fiscally and socially responsible bill. The bill passed unanimously.

HB 2551, introduced by Rep. Regina Cobb (R – Kingman), would allow a member eligible for the Children’s Health Insurance Program (CHIP), also known as KidsCare, to remain eligible for 12 months unless the member exceeds the age of eligibility (18 years and under) during that 12 month period. Currently, members remain eligible for only 6 months before their eligibility based on income-level is re-evaluated. 

According to proponents of the bill, this has resulted in many members suddenly losing their eligibility due to month-to-month income fluctuations.

“AHCCCS goes through this cycle where families get disenrolled when their income gets a little too high … and the child winds up having to re-enroll the next month because their income once again qualifies under normal circumstances,” said Zaida Dedolph, director of health policy at the Children’s Action Alliance, who testified in favor of the bill.  We know that this has an impact on health and on health care spending, even temporary gaps in health insurance coverage can increase health care costs overall to the system.” 

She emphasized that this simple solution would have far-reaching benefits.

“We know that kids who are covered continuously throughout the year do better in school, they’re more likely to graduate, they earn more as adults, and they’re less likely to participate in Medicaid in their own adulthood as well.”

Rep. Kelli Butler (D – Scottsdale) echoed her support of the bill. HB 2551 passed with a 10-2 vote, with opposing votes coming from Rep. John Kavanagh (R – Fountain Hills) and Rep. Jake Hoffman (R – Queen Creek).