State Officials Give Update On Private Option Medicaid Expansion

Jul 25, 2014

Arkansas State Capitol
Credit Chris Hickey / KUAR News

State officials say are addressing complications stemming from Arkansas's “private option.” On Thursday, state lawmakers got an update on the program which provides coverage for poor Arkansans.

So far, about 184,000 Arkansans have been determined eligible and about 176,000 people have gained coverage under the private option, acording to the state Department of Human Services. About 41 percent of enrollees are male and 59 pecercent are female. The average age is about 38. Officials also gave updates on the Health Insurance Marketplace, where more than 41,000 Arkansans signed up for coverage.

The DHS and Insurance Department officials spoke to state legislators at a meeting of the joint Health, Welfare and Labor Committee about the private option's many issues, among them: the insurance carrier Ambetter and its offering of Vision and Dental coverage to more than 19,000 people through the program. Medicaid officials say this has led to greater-than-estimated costs for state, which pays for coverage using federal Medicaid money available under the Affordable Care Act. As a result, the state says it would no longer allow those coverage options for any further enrollees. This was a concern of State Senator Stephanie Flowers.

“What pops up in my mind is deceptive trade. And it's being sanctioned by the state of Arkansas. And that's not right,” she said.

Flowers recently pushed DHS officials to add a disclaimer to Ambetter plans labeled as offering vision and dental, to say those coverage options will not be provided anymore. The state currently does not require that Dental and Vision benefits be included among the Essential Health Benefits (EHB's) covered by Qualified Health Plans (QHP's') available through the insurance Marketplace or the private option.

At the hearing, officials from the state Insurance Department, including deputy state Insurance Commissioner Cynthia Crone, presented an actuarial study showing what the average cost would be if the state allowed Dental and Vision Benefits to be offered across all plans through the private option and the non-private option Marketplace. It estimated the average added cost to premiums would be about 20 dollars per member per month. For the private option, that would mean a total cost of about 43 million dollars a year for the state, according to the study.

Another issue presented at the hearing was setting up some enrollees with a Health Savings Account, a sort of piggy bank for the times beneficiaries need to share the costs of coverage. The Health Savings Accounts (or Health Independence Accounts) will be phased in, first becoming available to those enrollees living at 100 to 138 percent of the Federal Poverty Level and who already share some of their costs through the program, said Arkansas Surgeon General Joe Thompson. He said the population living at 50 to 100 percent of the FPL will also eventually share costs and have access to HSA's.

“It'll be a phased implementation, with education being an important front-end piece before people are placed financially at significant risk,” he said.

The state is seeking a federal waiver for the Centers for Medicare and Medicaid Services for the HSA plan. Thompson said the plan should be finalized in August with the waiver request to be submitted in September.