ARIZONA Latino Children’s Health Coverage Facts State officials’ decisions about coverage options, especially in times of crises, have a profound effect on children and can exacerbate pre-existing racial and ethnic disparities. In Arizona, the uninsured rate for children overall is higher than the national average (8.3% vs 5.2%). Additionally, Latino children are more than 1.5 times as likely to be uninsured compared to other children in the state (10.4% vs. 6.6%). Removing barriers to Arizona Health Care Cost Containment System (AHCCCS) and KidsCare enrollment would help reduce this disparity. Latino Kids’ Coverage Arizona is home to over 80,000 uninsured Latino children The uninsured rate for Latino kids in Arizona is 10.4% 1.5x Latino kids in Arizona are more than 1.5 times as likely to be uninsured compared to other kids Medicaid and Latino Kids While AHCCCS and KidsCare are important sources of coverage for all children in Arizona, they are especially important for Latino children. Latino families have a higher labor force participation rate than others in the country, but are more likely to work in industries that do not offer employer-sponsored insurance (ESI). AHCCCS and KidsCare fill an important gap by providing affordable health coverage to these working families and while AHCCCS enrollment is always open, KidsCare enrollment was closed between 2010-2016. Medicaid/CHIP is the Largest Source of Coverage for Latino Kids Coverage Sources for Kids in Arizona, 2018 All Kids 5.1% 3.2% Covering Parents 8.3% 43.7% 39.7% Uninsured i Helps Children ESI Having health insurance like Medicaid/ Medicaid improves families’ Latino Kids 3.3% 2.7% CHIP health and economic security. Direct When adults’ health care purchase needs are met, they are better 10.4% 31% 52.6% equipped to support their Other children as they grow and learn. 0% 20% 40% 60% 80% 100% June 2020 GEORGETOWN UNIVERSITY CENTER FOR CHILDREN AND FAMILIES | UNIDOS US 1 Latino Child Trends Over Time 25% 21.5% 18.8% 20% 16.4%* 17.6% 17.5% Coverage Disparities Persist 16.0% Latino Child Uninsured Rates, 2008-2018 13.8%* 15% 11.2% 11.7%* 11.1% All children in Arizona are significantly more likely 10.0% 10.3% 10.1% 10.4% 9.8%* 10.2% 9.5% to be uninsured compared to the national average. 10% 7.9%* 7.3% 6.2%* 6.6%^ Almost half (44.6%) of all children in Arizona are 9.7% 5.2%* 8.9%* 8.5%* 7.9%* 7.5%* 7.5% Latino. Coverage inequities between Latino children 5% 6.3%* and other children in Arizona narrowed from 2008 to 5.1%* 4.7%* 5.0%* 5.2%*^ 2018, but more work remains to be done. Between 2017 and 2018, the uninsured rate went in the wrong 0% 2008 2009 2010 2011 2012 2013 2024 2025 2026 2017 2018 2014 2015 2016 direction for all children in the state. Uninsured Rate for Latino Children in AZ National Uninsured Note: * Change significant at the 90% confidence level and relative to prior year. ^ Change Rate for All Children significant at the 90% confidence level (2016-2018). Uninsured Rate for Non-Latino Children in AZ Older Children are More Likely to be Uninsured Latino Child Uninsured Rates in Arizona by Age, 2016 and 2018 The uninsured rate for Latino children in Arizona decreased for children 12 years old and younger, while the rate was flat for teens ages 13 to 18. Yet Latino teens have the highest uninsured rates by age group at over 15%. Although over 97% of Arizona’s Latino 0-5 years old 6-12 years old 13-18 years old children are U.S. citizens, anti-immigrant rhetoric may 2016 2018 2016 2018 2016 2018 lead parents to not enroll or renew their children’s 8.2% 6.7% 9.9% 9.0% 15.3% 15.3% coverage out of fear. 15% 13.2% 14.0% Families in All Income Groups Struggle to Access 11.9% 12.1% Coverage 12% Latino Child Uninsured Rates in Arizona by Census Poverty 10.2% 10.5% Threshold, 2016 and 2018 9% 8.3% 8.0% The uninsured rate for Latino children in Arizona decreased for most income groups studied between 2016 and 2018. However, the uninsured rate for Latino 6% children in families earning between 200% and 249% of the poverty thresholds (about $40,400-50,300 for a family of 3) increased over the period studied. These 3% children have the highest uninsured rate at 14%. The disproportionate job losses among Latinos during 0% the COVID-19 pandemic could result in even more 0-137% of 138-199% of 200-249% of 250% of poverty coverage losses. poverty poverty poverty and over 2016 2018 2 GEORGETOWN UNIVERSITY CENTER FOR CHILDREN AND FAMILIES | UNIDOS US June 2020 Coverage Disparities by Race AI/AN Latino Children Have Highest Uninsured Rate Asian/Pacific 0.3% Share of Population and Latino Child Uninsured Rates by Race, Islander * The Census Bureau reports race and Latino ethnicity as 1.8% Black separate variables, and Latino children may be of any 3.0% race. In Arizona, the majority of Latino children identify 2.5% American Indian/Alaska as White (74.9%) and the uninsured rate for this group 20.6% Native is 10.2%. A smaller share of Latino children identify as Two or 12.9% American Indian/Alaska Native (AI/AN) (2.5%) but their More Races 14.4% uninsured rate is twice as high at 20.6%. This indicates 7.6% the value of targeted, culturally competent outreach in Other Race 3.8% reducing racial coverage disparities. White 10.2% 74.9% 10.2% The terms “Hispanic” and “Latino” are used interchangeably 0% 10% 20% 30% 40% 50% 60% 70% 80% by the U.S. Census Bureau and throughout this document to refer to persons of Hispanic descent; they may be of any race. Share of Latino Child “Latinx” may also be used to respect various gender identities Uninsured Rate, 2018 Population, 2018 and expressions. *Note: The uninsured rate for Latino children identifying as Asian/Pacific Islander is suppressed due to poor reliability. Top Arizona Counties and Congressional Districts with the Most Uninsured Latino Children, 2018 Counties and Congressional districts with large Latino child populations are more likely to have large numbers of uninsured Latino children, but state and local policies have an impact on the coverage rates. Number & Rate of Uninsured Latino Children by County Number & Rate of Uninsured Latino Children by in Arizona Congressional District in Arizona Number of Number of Latino Kids Latino Kids Congressional District County Uninsured Latino Uninsured Latino Uninsured Uninsured Rate (Geographic reference point) Kids Kids Rate Maricopa County 56,313 11.7% District 7 (Phoenix) 27,916 13.8% Pima County 12,595 10.2% DIstrict 3 (Southern Arizona) 19,942 11.6% Yuma County 5,677 12.6% District 4 (Flagstaff) 6,676 12.9% Pinal County 3,518 8.4% District 2 (Southeastern 5,874 9.0% Mohave County 1,370 13.3% Arizona) Yavapai County 1,366 12.2% District 9 (Prescott/Lake 5,767 8.6% Havasu/Yuma) Cochise County 859 5.9% District 6 (Northwest Valley) 5,534 11.7% Santa Cruz County 833 6.6% District 5 (East Valley) 5,526 10.3% Coconino County 692 9.9% District 1 (Phoenix/Tempe) 3,812 6.4% La Paz County 316 17.3% District 8 (Scottsdale/ 3,795 6.9% Fountain Hills) June 2020 GEORGETOWN UNIVERSITY CENTER FOR CHILDREN AND FAMILIES | UNIDOS US 3 Policy Recommendations Health coverage is more important than ever. Any prior gains must be preserved even as the economy falters. Some states have laid the groundwork to protect children by enacting policies to cover as many children as possible with more straightforward enrollment and renewal processes. Policymakers in Arizona can join these leaders and ensure that more children, including Latinos, receive health coverage by continuing to provide KidsCare funding and: Covering children in Adopting 12 months Ending KidsCare Waiving the 5-year waiting Covering all children KidsCare up to 250% continuous coverage in waiting period period for lawfully-residing regardless of citizenship of federal poverty line AHCCCS and KidsCare children and pregnant status women in AHCCCS and KidsCare i Most uninsured children are eligible but not enrolled in AHCCCS and KidsCare. To find out if your child is eligible for free or low-cost health coverage, go to www.insurekidsnow.gov. UnidosUS, formerly the National Council of La Raza (NCLR), is the nation’s largest Latino civil rights and advocacy organization. Through our unique combination of research, advocacy, programs, and a national network of nearly 300 community- based Affiliate organizations across the country, we simultaneously challenge the social, economic, and political barriers that affect Latinos in the United States. The Georgetown University Center for Children and Families (CCF) is an independent, nonpartisan policy and research center. As part of the McCourt School of Public Policy, CCF provides research, develops strategies, and offers solutions to improve the health of America’s children and families, particularly those with low and moderate incomes. For more information about the methodology and sources, visit: https://ccf.georgetown.edu/2020/06/29/fact-sheets-latino-childrens-health-coverage/ 4 GEORGETOWN UNIVERSITY CENTER FOR CHILDREN AND FAMILIES | UNIDOS US June 2020