State insurance panel: Switch coverage ‘navigators’
The Arkansas Health Insurance Marketplace should solicit a new set of contracts from organizations that will help people enroll for individual coverage during the open-enrollment period that starts Nov. 1, a state panel recommended Wednesday.
On behalf of the marketplace, the Boston-based Public Consulting Group hired two organizations that provided 15 outreach workers, known as navigators, from Oct. 1 through June 30.
The consulting firm paid the organizations, Enroll the Ridge of Jonesboro and Future Builders of Wrightsville, a total of $552,000 and was then reimbursed by the marketplace from fees the marketplace began collecting from insurers in December.
That arrangement allowed the navigators to start work in time to help people enroll during last year’s enrollment period, which ran from Nov. 1 through Jan. 31.
Before it started collecting the fee, the marketplace’s only source of funding was from a federal grant that could not be used to pay the navigators.
At a meeting Tuesday of the marketplace board’s Consumer Assistance Committee, marketplace spokesman Alicia McCoy said that Public Consulting Group, which did not charge a fee for administering the navigator contracts, did not want to continue its role in the arrangement.
“It’s not profitable for them,” she said.
The committee recommended that the board solicit proposals directly from organizations and award new contracts.
The committee didn’t say how much money should be spent, but McCoy said after the meeting that the marketplace probably will try to continue supporting 15 navigators.
Jim Miles, founder of Enroll the Ridge, said his organization plans to submit a proposal. Under its contract that ended June 30, he said, navigators fielded inquiries from about 13,000 Arkansans and helped about 10 percent of them enroll.
Of the 1,300 who signed up, he said, about two-thirds qualified for coverage under the state’s expanded Medicaid program, known as Arkansas Works. The rest signed up for non-Medicaid plans on the state’s health insurance exchange.
A call to Future Builders’ offices wasn’t returned on Wednesday.
Created by the state Legislature in 2013, the marketplace set up a state-run exchange for small-business health plans in 2015 using money from a $99.9 million federal grant.
At the request of Gov. Asa Hutchinson during his first year in office, the marketplace scrapped its plan to use the remaining grant money to establish an enrollment system for individual consumers.
Instead, the agency took over responsibility for certifying the plans sold on the individual exchange and providing information to consumers while continuing to rely on the federal enrollment system that allows consumers to sign up through healthcare.gov.
The 2010 Patient Protection and Affordable Care Act requires exchanges to have navigator programs and prohibits them from using exchange grants to pay for their operations.
In addition to consumers signing up during the new open-enrollment period, Arkansans who seek help from navigators could include about 60,000 people who would be moved off Arkansas Works under a proposal by Hutchinson that was endorsed by the Legislature this year.
The change, which has been submitted for federal approval, would limit Arkansas Works eligibility to adults with incomes at 100 percent of the poverty level, instead of 138 percent of the poverty level.
Most of those affected would be eligible for federal tax credits to help them buy coverage on the exchange. That assistance is available to many people who don’t qualify for Medicaid and have incomes of up to 400 percent of the poverty level.
If the state’s proposal is approved, Human Services Department officials have said they will terminate coverage for Arkansas Works recipients at a rate of about 5,000 a month starting early next year.
If the committee’s recommendation is approved by the full board at its meeting on Friday, the marketplace’s plans call for it to issue a request for proposals from navigator organizations on Monday and award contracts on Sept. 15.