Facing objections from legislators, the Arkansas Department of Human Services said Friday that the department has scrapped plans to hire 100 outreach workers to help people sign up for Medicaid under an expansion of the program authorized by the 2010 federal health-care overhaul and approved by the Legislature earlier this year.
Meanwhile, Insurance Commissioner Jay Bradford said he plans to present the Legislature with a contract for Planned Parenthood to provide seven outreach workers for a similar effort aimed at people eligible for other subsidies, after the group submitted a letter promising that no money for the contract would goto support abortion-related activities.
“I’m going to recommend it, certainly,” Bradford said.
Rep. John Burris, R-Harrison, said he doubts theLegislature’s Review Committee will approve the contract.
“Planned Parenthood represents the most divisive issue of an entire political generation, and health-care reform is the most divisive political issue of a second generation,” Burris said. “Keeping those two things separate and apart is a very wise thing.”
Under the Medicaid expansion approved by the Legislature, people with incomes of up to 138 percent of the poverty level will be able to enroll in a private insurance plan through an exchange, or marketplace, and have the premium paid by Medicaid. That income threshold is $15,860 for an individual or $32,500 for a family of four. An estimated 250,000 people will be eligible.
Enrollment will start Oct. 1 for coverage beginning in January.
The Human Services Department would have used $4 million in Medicaid funds - including $2 million in state tax revenue - to hire the 100 workers through contracts with the Health Department and other entities. That drew objections from Burris and other legislators who said they had been assured that no state money would go toward implementing the federal Patient Protection and Affordable Care Act.
On Friday, Human Services Department officials said the department had abandoned its plan to hire the workers in light of the objections.
The department’s director, John Selig, made the decision Thursday, spokesman Amy Webb said.
“What we’re looking at now is, what existing resources do we have and how best can we use them to accomplish the goal of outreach,” Webb said.
For instance, she said the department will likely review its data to identify recipients of food stamps and other assistance whose incomes will qualify them for the expanded Medicaid program. The department would then contact those people and encourage them to sign up for coverage. The department is still considering how it would help those people enroll.
“We do think there is a need for having someone who could help walk people through the plans,” Webb said.
She said the department is also developing procedures to automatically enroll those who begin the application process but fail to choose an insurance plan. People who are automatically enrolled would be given a chance to change plans if they wish, she said.
Working from Human Services Department offices, the 100 workers would have been in addition to 542 workers that the state Insurance Department plans to hire through similar contracts using $16 million in federal grant money.
The Insurance Department’s workers, however, will target people with incomes of up to 400 percent of the poverty level who will be eligible for tax-credit subsidies to help with premiums.
The federal Centers for Medicare and Medicaid Services has told the Insurance Department that the grant money can’t be used to enroll those who are eligible for Medicaid, said Cynthia Crone, a deputy commissioner at the department.
“There’s a huge hole now,” Crone said.
She said the Insurance Department might develop a plan for giving Medicaid-eligible applicants a “warm handoff” to the Human Services Department. She said it will be up to the Human Services Department to figure out how to help the applicants from there.
“We will do everything we can to support it working well for the consumer,” she said.
Burris, who supported the expansion of Medicaid through the private insurance plans under the so-called private option, said he’s skeptical of the claim that federal grant money can’t be used to help those eligible for Medicaid.
“I think we need to have a conversation with CMS [Centers for Medicare and Medicaid Services] about that,” Burris said. “It’s a good example of a federal policy that’s allowing no flexibilityto the state.”
He added that many of those who need help enrolling will be able to get it from an entity such as their employer or a health-care provider.
“We’ve got entities and organizations in place that have something to gain from what we’re offering,” Burris said. “We don’t necessarily have to hire a whole new level of bureaucracy.”
On Friday, the Legislative Council signed off on a Health Department request to hire 300 of the grant-funded workers under a contract with the Insurance Department. Approval came after a Health Department official repeatedly assured lawmakers that no state money would go toward the federally-funded contract.
Gov. Mike Beebe doesn’t object to Selig’s decision to abandon the plan to use Medicaid money to hire outreach workers, spokesman Matt De-Cample said.
“We’ve left it to DHS to decide what’s best,” DeCample said. “We’re working on as many ways as we can to get the information out and get people signed up.”
Earlier this month, the Insurance Department issued contracts to the Health Department and 25 other entities to provide outreach workers for its enrollment effort. A potential contract with Planned Parenthood, however, was delayed after Burris and other lawmakers objected.
This week, Planned Parenthood sent Bradford a letter, dated Wednesday, pledging its workers would not provide abortion-related services or any other healthcare services. Their only duties would be disseminating information about coverage options and helping peopleenroll in plans, the group said in the letter.
Bradford said the organization, through its health centers in Little Rock and Fayetteville, works with patients who would benefit from subsidized coverage.
“Seven out of 500 [workers] - it’s certainly not a deal breaker, but I hope it’s approved,” Bradford said.
With no debate, the Legislative Council did sign off Friday on a $12,500 Health Department contract with Planned Parenthood to provide HIV/AIDS education and outreach targeting blacks in Pulaski County.
Sen. David Sanders, R-Little Rock, co-chairman of the council’s Review Committee, said it’s “highly unlikely” that the committee would approve the Insurance Department’s Planned Parenthood contract, which he called a “needless injection of controversy” into the outreach effort.
Beebe supports Bradford’s decision to present the contract to the Legislature, De-Cample said.
“We’ve been told that its prospects are not strong, but still there’s a process, and we’re going to follow that process,” DeCample said. He said the governor will “honor whatever decision” the Legislature makes.
Front Section, Pages 1 on 06/22/2013