Non-Medicaid plan rolls dip by 331 in Arkansas

Enrollment in non-Medicaid plans on Arkansas' health insurance exchange fell slightly from April 21 to June 1 although the number of enrollees who had paid at least one month's premium increased, according to a report by the Arkansas Insurance Department.

Separately, a report by the U.S. Department of Health and Human Services shows that the Arkansans who had signed up as of May 12 were paying higher premiums on average than consumers in other states with federally run exchanges, even after federal tax-credit subsidies were taken into account.

The Insurance Department report, based on information collected from insurance companies, shows enrollment in the plans fell 331 people, from 40,574 as of April 21 to 40,243 as of June 1.

The number of people whose coverage was active, meaning they had paid at least one month's premium, rose 29 percent, from 28,650 to 36,948.

But the number of people who chose a plan but had yet to make a first premium payment fell by even more, from 11,924 to 3,295, leading to the overall drop in enrollment.

Deputy Insurance Commissioner Cynthia Crone noted that people may drop their coverage on the exchange for another form of coverage, such as employer-sponsored insurance.

Citing the increase in people with active coverage, she said, "I'm feeling like the trending is really positive."

Set up in every state under the 2010 federal health care overhaul law, exchanges allow people to shop for insurance coverage and apply for subsidies to help them pay for it.

Arkansas is among 36 states using a federally run exchange. The remaining states and the District of Columbia set up their own exchanges.

Under Arkansas' so-called private option, most people who qualify for coverage under the state's expanded Medicaid program can sign up for a plan on the exchange and have the premium paid by Medicaid.

The Medicaid expansion extended eligibility to adults with incomes of up to 138 percent of the poverty level: $16,105 for an individual, for instance, or $32,913 for a family of four.

According to numbers released by the state Department of Human Services, more than 152,000 Arkansans were enrolled in the Medicaid-funded plans as of May 31.

Those who don't qualify for Medicaid may be eligible for federal tax credits to help them buy coverage. The tax credits are available to those with incomes of less than 400 percent of the poverty level: for example, $45,960 for an individual or $94,200 for a family of four.

To be eligible for the tax-credit subsidies, an applicant also cannot have access to employer-sponsored coverage that is considered affordable, meaning it would cost less than 9.5 percent of the employees' income.

While those who qualify for Medicaid can enroll at any time, others are mostly limited to signing up during annual enrollment periods.

The initial enrollment period was from Oct. 1 through March 31. Those who started enrollment before March 31 were given additional time to complete the process. People also can enroll outside of the enrollment period after certain events, such as losing job-based coverage.

From April 2 to June 1, the Insurance Department report shows the number of plans listed as being canceled fell from 4,091 to 1,694.

To avoid counting the same enrollees twice, Insurance Department officials said a plan that had once been listed as canceled should be taken out of that total if the person who had been enrolled in it signs up for another plan with the same company.

In preparation for the latest report, the department asked insurance companies to make a greater effort to exclude such plans from the total counted as being canceled.

The change "is giving us a truer picture of the active status of our enrollees," Insurance Department spokesman Heather Haywood said.

Max Greenwood, a spokesman for Arkansas Blue Cross and Blue Shield, said more than 28,000 non-Medicaid enrollees had active coverage with the company or its national affiliate, the Blue Cross and Blue Shield Association, as of June 2.

John Ryan, chief executive of Centene Corp.'s Arkansas Health and Wellness Solutions, which offers plans under the name Ambetter Arkansas, declined to say how many people had enrolled in plans with his company.

A spokesman for Little Rock-based QualChoice Health Insurance didn't respond Tuesday to a request for information about her company's enrollment.

According to the report by federal Health and Human Services Department, 89 percent of Arkansas enrollees who were not eligible for Medicaid did qualify for tax credits, compared with 87 percent of enrollees in all the states using federal exchanges.

Arkansans who qualified for the tax credits selected plans with an average monthly premium of $387, compared with an average premium of $346 among the plans selected by enrollees in all the federal exchange states.

After the tax credits were applied, the Arkansans paid an average premium of $94, compared with $82 among those who qualified for the credits in all the federal exchange states.

The after-tax-credit premiums also were higher than average for Arkansans when examining only those who selected silver-level, or midrange plans.

Arkansans who signed up for those plans and qualified for tax credits paid an average of $83, compared with $69 among all those who selected silver plans in the federal exchange states.

Silver plans are the only ones that include additional federal subsidies to reduce out-of-pocket expenses for individuals with incomes below 250 percent of the poverty level.

Crone said Arkansas' average premiums, after the tax credits are factored in, could be higher than some other states because the average incomes of those signing up in other states could be lower, allowing those enrollees to qualify for bigger subsidies.

For instance, in states that did not expand Medicaid, people with incomes as low as the poverty level are eligible for tax-credit subsidies. In Arkansas and other states that expanded Medicaid, most adults with incomes below 138 percent of the poverty level are not eligible for the tax credits because they qualify for Medicaid.

A Section on 06/25/2014

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