A state board would spend more than $550,000 on a program to provide outreach workers to help people enroll through Arkansas' health insurance exchange under a proposal endorsed by members of a board committee on Wednesday.
Operating a program to provide such health insurance "navigators" will be required if the Arkansas Health Insurance Marketplace, a nonprofit created by the state Legislature, receives federal approval to take over the state's health insurance exchange for individual consumers, as Gov. Asa Hutchinson has proposed.
Under Hutchinson's proposal, Arkansas would continue to use the federal system, including the healthcare.gov website, to enroll consumers but would have responsibility for conducting consumer outreach and setting standards for insurance plans offered on the exchange.
At a meeting of the Marketplace Board's Consumer Assistance Committee on Wednesday, representatives of the Boston-based Public Consulting Group estimated that $552,363 would pay for about 15 full-time navigators, which the firm estimated would be enough to meet the state's needs.
Money to pay the workers would ultimately come from a 3 percent premium fee on plans sold on the state's insurance exchange that the Arkansas Health Insurance Marketplace hopes to begin charging next year.
The full marketplace board is expected to vote on the proposal at its next meeting, on Sept. 21.
State Rep. Bob Ballinger, R-Hindsville, said after the meeting that he hopes the state can request a waiver exempting it from having to provide navigators.
He doesn't want taxpayer dollars to go toward encouraging people to sign up for government assistance, especially when enrollment in Medicaid-supported plans offered through the insurance exchange has already exceeded expectations.
"It sounds like we're in a little bit of a pickle with how we're going to cover the programs that we already have," Ballinger said. "We don't need to be stepping out and extending ourselves into more programs."
Established in every state under the 2010 Patient Protection and Affordable Care Act, exchanges help consumers shop for coverage and apply for subsidies to help pay for them.
In Arkansas, more than 319,000 Arkansans were enrolled in exchange coverage as of Aug. 15. That included more than 258,000 low-income Arkansans whose premiums were paid by the state Medicaid program under the private option as of June 15 and more than 61,000 enrolled in non-Medicaid plans.
The Legislature created the Arkansas Health Insurance Marketplace in 2013 to set up state-run exchanges for small businesses and individual consumers.
Using money from a $99.9 million grant, the agency established the small-business exchange last year.
But Hutchinson has said he doesn't see the need to spend millions of dollars establishing the individual exchange.
Instead, he wants the state to take over responsibility for the exchange while continuing to use the federal enrollment system.
As part of the move, Hutchinson hopes to lower the fee charged to insurance companies that offer plans on the exchange.
Currently the federal Centers for Medicare and Medicaid Services charges the companies a fee equal to 3.5 percent of the premiums for the plans sold on the exchange.
If Arkansas takes over the individual exchange, the federal agency will no longer charge the 3.5 percent fee next year, but Arkansas will have to pay the federal agency a fee equal to 1.5 percent of the exchange plan premiums.
Marketplace Board Chairman Mike Castleberry said Wednesday that the state marketplace agency hopes to charge a 3 percent fee to cover the federal fee as well as pay for exchange operations, including the navigator program.
Currently the board's only source of revenue is the $99.9 million grant. But that money can't be spent on navigator programs.
Castleberry and Brett Kirkman, the only other consumer assistance committee member who attended Wednesday's meeting, said they will recommend accepting Public Consulting Group's offer to provide the initial money for the navigator program during the open enrollment period that starts Nov. 1 for coverage beginning in 2017.
The Health Insurance Marketplace, which is using grant money to pay the Public Consulting firm for other services under a two-year, $3 million contract, would then reimburse the consulting firm for the navigator program after it begins collecting fees from insurers on Jan. 1.
Under the proposal, the firm would issue contracts to at least two different entities to provide the navigators.
Since enrollment in exchanges began nationwide in 2013, the federal government has awarded grants to nonprofit groups and other organizations to provide navigators in Arkansas and other states with federally operated exchanges.
Last year, federal navigator grants totaling $737,000 went to the University of Arkansas' Partners for Inclusive Communities and Jonesboro-based Enroll the Ridge.
Through contracts with nonprofit groups, the Arkansas Insurance Department also used federal grant money to hire more than 500 outreach workers in 2013. But that program ended after special language attached to the appropriation bills of the Insurance, Health, and Human Services departments prohibited those agencies from promoting enrollment after June 30, 2014.
Rep. Nate Bell, I-Mena, proposed the bans as a way of slowing enrollment in the private option while winning the support of enough conservative Republicans to avoid a stalemate over funding for the program.
During this year's fiscal session, Ballinger proposed special language, attached to the Department of Higher Education, that prohibited any state college or university from operating navigator programs after June 30.
Partners for Inclusive Communities, which researches issues faced by disabled people, ended its navigator program on June 30 because of the special language, Director David Deere said.
Metro on 08/25/2016