Arkansas panel: For agency, renew Medicaid-outreach ban

Arkansas' Insurance Department should continue to be prevented from promoting enrollment in the state's expanded Medicaid program next year, a legislative subcommittee recommended Wednesday.

The recommendation would extend the ban on consumer outreach, in place since 2014, by replacing references to the Health Care Independence Program, the official name of the private-option Medicaid expansion.

Instead, "Arkansas Works," the new name for the program that includes the private option, would appear in the Insurance Department's appropriation bill for the fiscal year that begins July 1.

Rep. Douglas House, R-North Little Rock and a chairman of the subcommittee, said he expects the special language recommendation to be presented to the full Joint Budget Committee today.

Lawmakers haven't yet begun reviewing possible updates to similar restrictions that have been imposed on the state departments of Health and Human Services since 2014.

In a statement, Gov. Asa Hutchinson said an outreach campaign commissioned by the Human Services Department will be critical to moving enrollees from the private option to subsidized, job-based coverage under Arkansas Works.

The restrictions on private-option outreach by the Human Services, Health and Insurance departments in effect during the current fiscal year don't mention Arkansas Works, which will begin Jan. 1 if approved by the federal government.

"Arkansas Works has been approved and funded by the Legislature, and I would prefer the Legislature to give maximum flexibility in implementing the reforms included in Arkansas Works," Hutchinson said in the statement.

Regarding the outreach campaign mentioned by the governor, Human Services Department spokesman Amy Webb said Wednesday that the department plans to pay for the effort, carried out by the Arkansas Health Insurance Marketplace, to encourage businesses to sign up for financial help under Arkansas Works to provide job-based coverage to their employees.

An Aug. 17 agreement calls for the department to pay the marketplace up to $300,000 for that effort through July 7.

Sen. Bart Hester, R-Cave Springs, who opposed the private option and Arkansas Works, said he hopes the restrictions on marketing will be extended to include both programs.

He expects legislation will be introduced during next year's session that also would prohibit the Arkansas Health Insurance Marketplace, a nonprofit created by the Legislature, from promoting enrollment in Arkansas Works or other coverage through the state's health insurance exchange.

"We're giving away more insurance than we can [afford] already," Hester said. "We certainly don't need to be spending money to give away something else that we can't afford."

Rep. Bob Ballinger, R-Hindsville and another private-option opponent, said he supports continuing the ban on outreach for the private option and other health care exchange coverage and extending the ban to include the Arkansas Health Insurance Marketplace.

He said he doesn't yet know whether the ban should extend to efforts encouraging employers to participate in Arkansas Works.

The original restrictions were proposed by Rep. Nate Bell, I-Mena, as a way of winning support for approval of the appropriation bill for the Human Services Department's Medical Services Division, legislation that included funding for the private option.

Opponents of the private option have targeted the annual appropriation bill as a way to try to block funding for the expanded Medicaid program. The bill requires a three-fourths majority of each chamber of the Legislature to pass.

Despite the restrictions on outreach, enrollment in the private option has soared beyond state officials' expectations, reaching 301,009 as of Sept. 30.

The Legislature created the private option in 2013 as a primary way of extending Medicaid coverage to adults with incomes of up to 138 percent of the poverty level: $16,394 for an individual, for instance, or $33,534 for a family of four.

The insurance exchange also makes income-tax credit subsidies available to many people who don't qualify for Medicaid and have incomes of below 400 percent of the poverty level: $47,520 for an individual, for example, or $97,200 for a family of four.

Those who qualify for Medicaid can sign up at any time. For others, enrollment through the exchange for coverage in 2017 starts Tuesday and continues through the end of January.

To encourage sign-ups, the Arkansas Health Insurance Marketplace is planning a campaign that will include radio, television and print advertising, as well as meetings with insurance agents across the state.

Little Rock advertising firm Cranford Johnson Robinson Wood is carrying out the marketing campaign under a two-year, $5.8 million contract awarded by the marketplace last year.

Through a contract with Boston-based Public Consulting Group, the marketplace also plans to spend up to $550,000 to provide 15 outreach workers, known as "navigators," to provide one-on-one help with enrollment.

Money for the advertising contract is coming from a $99.9 million federal grant the marketplace received in late 2014.

The marketplace will pay for the navigators through a fee it plans to begin collecting from insurance companies that sell plans on the exchange next year.

The Joint Budget Committee's Special Language Subcommittee recommended, with little discussion Wednesday, the change barring the Insurance Department from promoting enrollment in Arkansas Works after June 30.

Insurance Department spokesman Ryan James said the department does not have any plans to promote enrollment in Arkansas Works or the health insurance exchange.

A Section on 10/27/2016

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