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NASCIO AwardsHealth-e-Arizona

NASCIO Recognition Award Nomination:  Health-e-Arizona

Category:  Digital Government:  Government to Citizen


Health-e-Arizona provides a digital network technology solution to the problem of the cumbersome application process for Medicaid and other publicly funded health insurance programs in Arizona by automating the application process and providing that automated application process to interested parties through Internet broadband technologies. The latest figures of the U.S. Census bureau show that nationally over 41 million Americans did not have health care coverage in 2001. A slow economy, high unemployment and rising health care costs likely mean that more Americans became uninsured in 2002.

Widespread lack of health care coverage affects not only the uninsured and their families, but also the communities in which they live and the greater society. The problems of the uninsured take a financial toll on everyone, not just the uninsured themselves. Because the uninsured tend to wait longer to seek treatment, they are often very ill when they finally receive care. And when they do seek care, they frequently turn to the nearest hospital emergency room, an expensive and inefficient way to get care. In the emergency room, uninsured patients may run up huge medical bills that can take years to pay.  In many cases, hospitals, businesses, insurers and taxpayers are left to shoulder the costs that patients are unable to pay.

Care for the uninsured is paid for by everyone, often in inequitable ways. Many hospitals and physicians in this country provide charity care to low income, uninsured patients at no or reduced charge. But that care does impose a cost on society. It is often paid for indirectly by insured patients, who wind up with higher charges as a result. Clearly, when tens of millions of people lack access to adequate health care because they are uninsured, the consequences to individuals, families, communities and society can be enormous.

It has been well documented that many of the uninsured in this country are in fact eligible for coverage under government health insurance coverage for low income persons. Although Medicaid programs insured 13.3 million poor people in 2001, a surprising 10.1 million, or 30.7% of poor people still had no health insurance in that period of time. The uninsured poor comprised 24.5 percent of all uninsured people in 2001. Among the near poor (between 100% and 125% of the federal poverty level), 26.5% lacked health insurance in 2001. Medicaid is the most widespread type of health insurance among the poor and near poor, but coverage by Medicaid of this population did not change statistically from 1999 to 2001.

In Arizona, despite a recent successful legislative initiative which increased the eligibility threshold for AHCCCS (Arizona’s Medicaid) to 100% of the federal poverty level, 18.4 percent of Arizonans are uninsured, compared with 14.5 percent nationally.

Cost is not the only barrier to accessing health insurance. With the advent of the SCHIP program offering government health insurance to low income children, and the subsequent failure of the various state SCHIP programs to reach the eligible child population for enrollment, there has been much speculation about the reasons for that failure. The Children’s Action Alliance held eleven focus groups in 1999 with low income parents from across Arizona to discuss their experiences and perceptions of the AHCCCS application and eligibility process. While participating parents came from different kinds of communities and households, they consistently and repeatedly identified “excessive” and “complicated paperwork” as a main barrier to applying for and enrolling in public insurance programs.

El Rio Health Center, in partnership with the Arizona Department of Economic Security (DES) and the Arizona Health Care Cost Containment System (AHCCCS), is using Health-e-Arizona’s digital network technology to automate the application process for

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