Arkansas Democrat-Gazette

Bill asks pause to care changes

Se­na­tor: Pro­posed task force needs time on pri­vate op­tion

- ANDY DAVIS Poverty · U.S. News · Society · Asa Hutchinson · Little Rock · Arkansas · Jim Hendren · Sulphur Springs, AR · Australian Department of Human Services

The bill that would cre­ate a task force to study a re­place­ment pro­gram for Ar­kan­sas’ pri­vate op­tion would also sus­pend the im­ple­men­ta­tion of “in­de­pen­dence ac­counts” for en­rollees with in­comes be­low the poverty level.

Se­nate Bill 96, spon­sored by Sen. Jim Hen­dren, R-Sul­phur Springs, also would sus­pend ef­forts to move chil­dren now cov­ered by the ARKids First B Med­i­caid pro­gram as well as adults now cov­ered by the tra­di­tional Med­i­caid pro­gram into cov­er­age of­fered through the state’s in­surance ex­change.

The so-called in­de­pen­dence ac­counts and the tran­si­tion of peo­ple cov­ered by Med­i­caid into ex­change cov­er­age is man­dated by Act 1498 of 2013, which cre­ated the pri­vate op­tion.

Spe­cial lan­guage passed dur­ing the Leg­is­la­ture’s fis­cal ses­sion last year also man­dates that the state Depart­ment of Hu­man Ser­vices im­ple­ment the in­de­pen­dence ac­counts and re­quire en­roll-

ees with in­comes of 50-100 per­cent of the poverty level to help pay the cost of their med­i­cal care.

The fed­eral poverty level is $11,670 for an in­di­vid­ual and $23,850 for a fam­ily of four.

Hen­dren said sus­pend­ing those man­dates would save tax­payer money and help the task force as­sess the pri­vate op­tion’s per­for­mance.

“It’s hard to as­sess how a pro­gram’s per­form­ing if it’s chang­ing,” Hen­dren said. “This ba­si­cally puts the pro­gram on pause so the task force can look at how it’s per­formed and what if any­thing is go­ing to fol­low it.”

Hen­dren’s bill calls for the planned changes to be sus­pended un­til Dec. 31, 2016, or un­til the pri­vate op­tion is ter­mi­nated, which­ever comes ear­lier.

The task force is part of an effort an­nounced Thurs­day by Gov. Asa Hutchin­son to craft a plan that would re­place the pri­vate op­tion af­ter Dec. 31, 2016, when the fed­eral waiver au­tho­riz­ing the pro­gram ex­pires.

Ar­kan­sas cre­ated the pri­vate op­tion as a pri­mary way to ex­pand Med­i­caid cov­er­age to adults with in­comes up to 138 per­cent of the poverty level: $16,105 for an in­di­vid­ual, for in­stance, or $32,913 for a fam­ily of four.

More than 188,000 Arkansans were cov­ered by the pro­gram as of Nov. 30, while more than 25,000 other newly el­i­gi­ble adults were as­signed to the tra­di­tional Med­i­caid pro­gram be­cause they had health needs that were con­sid­ered to be ex­cep­tional.

Hutchin­son said Thurs­day that he will ask the Leg­is­la­ture to con­tinue fund­ing for the ex­panded Med­i­caid pro­gram through 2016, while the task force, made up of 16 leg­is­la­tors and Sur­geon Gen­eral Greg Bled­soe, stud­ies al­ter­na­tives.

The task force’s rec­om­men­da­tions would be due by the end of this year.

The in­de­pen­dence ac­count pro­gram started this month for the 37,000 pri­vate op­tion en­rollees with in­comes above the poverty level.

It was ex­pected to start this sum­mer for the 60,000 en­rollees with in­comes be­tween 50-100 per­cent of the poverty level.

The pro­gram en­cour­ages en­rollees with in­comes greater than 50 per­cent of the poverty level to make pay­ments of up to $15 per month to help pay the cost of their med­i­cal care.

The con­tri­bu­tions ac­cu­mu­late in an ac­count, with the bal­ance capped at $200. En­rollees who leave the pri­vate op­tion can use the money to pay the pre­mi­ums for non-Med­i­caid in­surance plans.

En­rollees who con­trib­ute to an ac­count in a given month don’t have to pay out of pocket for their med­i­cal care for that month.

Cur­rently, en­rollees with in­comes above the poverty level have co­pay­ments for some ser­vices — $8 for a doc­tor’s of­fice visit, for in­stance. Those be­low the poverty level have no co­pay­ments.

Kate Luck, a spokesman for the state Depart­ment of Hu­man Ser­vices, said sus­pend­ing the im­ple­men­ta­tion of the pro­gram for en­rollees with in­comes be­low the poverty level would cut the pro­gram’s an­nual ad­min­is­tra­tive costs in half, from $12 mil­lion to $6 mil­lion. The state is re­spon­si­ble for half of those costs, and the fed­eral govern­ment is pay­ing the rest.

The move also would al­low of­fi­cials to make sure in­de­pen­dence ac­counts “work as ex­pected” for en­rollees with in­comes above the poverty level and to al­low the task force and depart­ment to fo­cus on “the long-term im­prove­ment and not get bogged down with in­terim steps,” Luck said in an email.

Sen. David San­ders, R-Lit­tle Rock and a spon­sor of the law creat­ing the pri­vate op­tion, said he sup­ports sus­pend­ing the changes to the pri­vate op­tion as out­lined in Hen­dren’s bill.

He wants to study the in­de­pen­dence ac­count pro­gram to see if it’s worth the ad­min­is­tra­tive cost be­fore ex­pand­ing it, he said.

He also wants to ex­plore whether the 65,000 chil­dren cov­ered by ARKids B could be cov­ered un­der their par­ents’ in­surance poli­cies.

“We have a law in this coun­try that says ev­ery­one has to have cov­er­age,” San­ders said, and pri­vate cov­er­age for chil­dren is less ex­pen­sive than cov­er­age for adults.

He added that he op­poses a Hu­man Ser­vices Depart­ment plan to move chil­dren now cov­ered by ARKids B onto the state’s Chil­dren’s Health In­surance Pro­gram plan. He said he would pre­fer the state ex­plore less ex­pen­sive op­tions. ARKids B cov­ers chil­dren in fam­i­lies with in­comes be­tween 147 per­cent and 216 per­cent of the fed­eral poverty level.

Hen­dren said he plans to pre­sent his bill to the Se­nate Com­mit­tee on Pub­lic Health, La­bor and Wel­fare on Mon­day or Wed­nes­day. If it’s ap­proved, he said he hopes to have a vote on it in the Se­nate later in the week.

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