Arkansas should stick for another year with the criteria it set last year for plans on the state's insurance exchange, an advisory panel recommended Friday.
The exchange's Plan Management Advisory Committee -- made up of state officials, insurance industry representatives, health care providers and consumers -- made the unanimous recommendation after reviewing past decisions on the rules for plans offered on the federally run exchange.
However, state Rep. Allen Kerr, who is expected to take over as the state's insurance commissioner Tuesday, indicated that he'll be giving the state's insurance programs a fresh look.
"They're pretty much like a young child in adolescent stage," Kerr, R-Little Rock, told the advisory panel. "It's going to be doing a lot of growing, a lot of changing as time goes on.
"We're going to find out where the flaws are, hopefully, and fill those in."
Kerr also expressed confidence in the committee.
"I'm convinced that Arkansas is a leader in these types of programs and health care," Kerr said. "With all the brain power in this room, I'm extremely impressed and intimidated, but I know we've got the best people on the job."
Established under the 2010 federal health care overhaul law, the exchange allows people to shop for coverage and apply for subsidies to help pay for it.
As of Dec. 15, more than 233,000 Arkansans were enrolled in plans on the state's exchange, including more than 188,000 whose premiums are paid with federal Medicaid funds under the state's so-called private option.
Plan management committee recommendations implemented by outgoing Insurance Commissioner Jay Bradford included dividing the state into seven service and rating regions in which plans can be offered and allowing companies to offer as many plans as they want, as long as they can show a "meaningful difference" between the plans in accordance with federal regulations.
Federal rules require each company that offers plans to have at least one gold-level plan, designed to cover 80 percent of a typical patient's medical expenses, and one silver-level plan, designed to cover 70 percent of a patient's expenses.
Last year, Arkansas also began requiring each company to offer one silver plan that includes only the benefits required by state and federal law.
Those plans are the ones available to Arkansans who qualify for Medicaid-funded coverage under the state's so-called private option.
In advocating to keep the criteria the same, committee members said they didn't know of a reason to change them, and they noted that insurance companies will face a tight deadline for submitting the rates and other details of their plans to the Insurance Department.
In December, the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services notified insurers that it tentatively planned to set April 15 as the deadline for submitting the plans they hope to offer for coverage taking effect in 2016.
That would mean companies would have to submit the plans to the Arkansas Insurance Department by March 15.
The committee's recommendations, which apply to plans offered to individual consumers, will go to the exchange's steering committee, which meets Jan. 21.
Kerr will make the final decisions for a bulletin expected to be issued to insurance companies next month.
The Arkansas Health Insurance Marketplace, a nonprofit organization created by the Legislature, will make recommendations on the criteria for small-business plans, covering 106 people as of Dec. 15, that are offered in the state's exchange for small businesses.
The marketplace plans to use a more than $99 million federal grant to establish a state-run small-business exchange this year, for coverage taking effect in 2016, and an exchange for individuals next year, for coverage taking effect in 2017. Both exchanges would replace the ones set up for the state by the federal government.
Once the state-based exchanges are established, the Health Insurance Marketplace will have the final say on the state's criteria for the plans.
Metro on 01/10/2015