Childless Adults Continuation Waiver

 On January 14, 2013, Governor Brewer announced her proposal regarding Medicaid coverage. Details about her plan will be released in the near future. Her recommendation will now be considered by the Legislature in the 2013 legislative session. Please visit the link below for more information about the Medicaid Coverage proposal.

Medicaid Coverage



Governor Brewer continues to review options available to the State regarding the path ahead for the AHCCCS program in light of the Supreme Court’s ruling making the Medicaid Coverage optional for states. As Governor Brewer deliberates and continues stakeholder engagement efforts, there are key questions that remain unanswered. Among those is whether states like Arizona that already provide Medicaid coverage to childless adults can obtain an enhanced federal match rate beginning in January 1, 2014. Because Prop. 204 already mandates that AHCCCS cover all Arizonans up 100% of the federal poverty level, including childless adults, Arizona is not eligible for the 100% federal funding for this population. Arizona is only eligible for an enhanced federal match for its childless adult population. Whether Arizona can obtain the enhanced federal match rate is critical in the Governor’s decision making as to whether the State can consider restoring coverage for childless adults.

Federal Interface

December 13, 2012
On December 10, 2012, CMS informed Governors that states will not receive enhanced federal funding unless their programs provide coverage to the fullest extent under the Affordable Care Act (up to 133% FPL). CMS provided the State specific guidance that requests such as the one proposed in Arizona’s Childless Adults Waiver (Childless Adults 0-100% FPL), would not be eligible for enhanced federal funding. Thus, Arizona can only obtain enhanced federal funding for the coverage of Childless Adults if Medicaid provides coverage up to 133% FPL. The CMS FAQ link below provides additional information. Arizona is still awaiting a formal reply from CMS on its Childless Adults Waiver request and whether it can continue coverage of Childless Adults under the 1115 Waiver beyond 2013. More information will be posted as it becomes available.

CMS FAQs 12/10/12

On November 9, 2012, AHCCCS submitted a waiver amendment to the Center for Medicare and Medicaid Services (CMS), the federal agency that partners with states to administer their Medicaid programs. This amendment allows AHCCCS to maintain its current authority to offer coverage to childless adults at an enhanced federal medical assistance percentage (FMAP), within available resources. Without CMS approval, AHCCCS will no longer have the federal authority to cover childless adults in its program beginning January 1, 2014. If the waiver is not approved, and no other action is taken, AHCCCS will have to eliminate coverage for all remaining childless adults enrolled in AHCCCS beginning January 1, 2014.

This amendment request does not reflect any decision on the part of Governor Brewer about the future of Arizona’s Medicaid program, but it preserves the State’s options and provides flexibility for policymakers to conduct a thoughtful approach to examining coverage opportunities for Arizona citizens.

Waiver Proposal 11/9/12
Draft Waiver Proposal 9/18/12

Public Input Process

September 18, 2012
AHCCCS has been involved in a variety of stakeholder efforts to inform and accept feedback from the public regarding the coverage of Childless Adults and Coverage of Medicaid. The links below include additional information from these stakeholder efforts.

Stakeholder Input Common Themes

  • Public Meetings
    A summary of each of the 7 public meetings, which includes a summary of the public’s testimony, is provided in the link below.

Public Meeting Summary

AHCCCS will host public meetings to provide additional information about the Childless Adult Draft Waiver Amendment. Click on the link below for more information about the public meeting, including the date, location and how to RSVP.

Childless Adults Agenda
Meeting Materials

  • Written Comments
    AHCCCS reviewed and considered all of the written comments received within the 30 day comment period and has posted them in the link below.

Childless Adults Written Comments
Referenced Attachments

In addition to the public meetings, AHCCCS accepted written public comments. The DRAFT Waiver amendment was open for public comment for 30 days and closed October 19, 2012. AHCCCS reviewed and posted all public comments received.

Submit a public comment by: (The comment period is closed)


Or by mail:
Attn: Office of Intergovernmental Relations
801 E. Jefferson, MD 4100
Phoenix, AZ 85034