The former director of Utah’s health insurance exchange on Wednesday was offered the job as director of the entity that is exploring creating a state-run health insurance exchange in Arkansas.
Meanwhile, the Arkansas Department of Human Services reported that nearly 150,000 Arkansans had been approved for coverage as of Saturday under the state’s expanded Medicaid program, an increase of more than 5,300 from a week earlier.
Most of those enrolling under the expanded Medicaid program receive coverage through private plans offered on Arkansas’ federally run insurance exchange, with the premiums paid by Medicaid.
Set up in every state under the 2010 federal health-care overhaul law, exchanges allow people to shop for coverage and apply for subsidies to help them pay for it.
Arkansas is among more than 30 states with a federally run exchange. The remaining states opted to set up their own exchanges.
Act 1500, passed by the Legislature last year, created the Health Insurance Marketplace Board and directed it to decide whether Arkansas should take over the operation of its health-insurance exchange from the federal government.
Cheryl Smith, a consultant with Deloitte Consulting who advises state government officials on matters related to insurance exchanges, was one of four applicants interviewed by the board to become the organization’s first executive director.
State Rep. Mark Biviano, R-Searcy, who sponsored Act 1500, applied for the position but was not among the finalists.
After meeting in executive session Wednesday, the board voted unanimously to offer Smith the job.
Board member Fred Bean said Smith would be paid an annual salary of $165,000.
Smith told the board she would respond to the offer Monday.
In a phone interview with the Arkansas Democrat-Gazette after Wednesday’s meeting, Smith cited Arkansas’ approach to expanding Medicaid as a reason for her interest in the job.
The state was the first in the country to receive approval from the U.S. Department of Health and Human Services to use Medicaid funds to pay for coverage in plans offered on the insurance exchange.
Iowa has since received approval to use a similar approach. New Hampshire plans to seek approval for a similar plan.
“People may love what Arkansas has decided to do, and they may hate it, but either way it’s got people talking and thinking, and that can only be a good thing,” Smith said.
Approved by the Legislature last year, the expansion of the Medicaid program extended coverage to adults with incomes of up to 138 percent of the poverty level: for example, $16,105 for an individual and $32,913 for a family of four.
The 149,666 people who had been approved for coverage as of Saturday included at least 106,324 people who were enrolled in plans on the insurance exchange under the state’s so-called private option.
In addition, 14,969 people were assigned to the traditional Medicaid program because they were determined to have exceptional health needs.
Thousands of others who had been approved for coverage as of Saturday had not yet completed enrollment.
The expansion made an estimated 250,000 people eligible for coverage.
“We can really tell there was a big need in Arkansas,” Human Services Department spokesman Kate Luck said.
Also Wednesday, the Arkansas Insurance Department reported that 33,569 people who did not qualify for Medicaid had enrolled in plans on the exchange as of Monday, an increase of 6,142 from two weeks earlier.
For coverage taking effect this year, enrollment began Oct. 1 in expanded Medicaid programs in Arkansas and other states, as well as in other coverage available through the exchanges.
The Health Insurance Marketplace Board is using a $3.6 million grant from the federal Centers for Medicare and Medicaid Services to fund the salary of its director and pay for other functions.
Board member Steve Faris had said the salary should be at least $10,000 less than Insurance Commissioner Jay Bradford’s, which is $129,525.
But board member Bean said Wednesday that the finalists interviewed by the board made it clear that a higher salary would be needed.
Smith “would be taking a little pay cut” by accepting the Arkansas job, Bean said.
From May 2008 to July 2010, Smith was director of policy and strategy for the Utah exchange, which facilitates coverage offered by small businesses. Along with the one in Massachusetts, the Utah exchange is one of two state health insurance exchanges that predates the 2010 Patient Protection and Affordable Care Act.
Like Arkansas, Utah is relying on the federal exchange to offer subsidized coverage to individuals.
According to her resume, Smith, 44, also worked as a visiting policy fellow for the conservative Heritage Foundation from May 2007 to January 2009.
“She has a national reputation that’s very positive,” Bean said. He added that Smith also has experience working with consumers as well as legislators, insurance agents and others.
Under the health-care law, federal tax-credit subsidies are available through the exchanges to those who don’t qualify for Medicaid but have incomes below 400 percent of the poverty level: for example, $45,960 for an individual and $94,200 for a family of four.
Not including the subsidy, the average monthly premium among the non-Medicaid eligible who had signed up as of Monday is $400, according to information presented to the board Wednesday by Deputy Insurance Commissioner Cynthia Crone.
Silver plans, designed to cover 70 percent of a typical patient’s medical expenses, have been the most popular choice, with 67 percent of those who enrolled in non-Medicaid plans choosing that level.
About 17 percent of the enrollees chose bronze plans, designed to cover 60 percent of medical expenses, and 15 percent chose gold, which is designed to cover 80 percent of a patient’s expenses.
About 28 percent of non-Medicaid enrollees were age 34 or younger, while 33 percent were ages 55 to 64.
Those who qualified for the Medicaid-funded coverage tended to be younger. Including 51,511 private-option enrollees for whom the insurance companies had information, 38 percent of those customers were age 34 or younger, while 19 percent were ages 55 to 64.
The insurance companies offering plans on the exchange are required to include private-option enrollees and those who do not qualify for Medicaid in the same risk pool, meaning their combined medical expenses will be used in calculating premiums in future years.
For those who do not qualify for coverage, the deadline to sign up for coverage starting in 2014 is Monday. But federal officials said this week that additional time will be given to those who say they tried to sign up by the deadline but were unsuccessful.
Holly Stevens, who supervises a team of 10 outreach workers at In Affordable Housing, a Little Rock nonprofit hired by the Insurance Department to help people enroll, said she’s noticed an increase in people seeking help during the past couple weeks.
“Right now, the phones are just flooded,” she said.
Arkansas, Pages 9 on 03/27/2014