Health hub panel urges slight funding rise

A committee of the Arkansas Health Insurance Marketplace recommended Wednesday that the agency slightly increase its spending on outreach workers to help people sign up for coverage.

The marketplace’s consumer assistance committee recommended that the agency pay Jonesboro-based Enroll the Ridge $554,391 to provide 11 of the workers, known as navigators, from Oct. 1 through Sept. 30.

Under an earlier contract, the marketplace paid Public Consulting Group of Boston $552,000 to provide 15 navigators for nine months, from Oct. 1 of last year through June 30. The consulting firm subcontracted the work to Enroll the Ridge and Future Builders in Wrightsville. The Wrightsville organization would be a subcontractor under the new contract.

The committee recommended that the new contract be written so that the number of navigators could be increased or decreased as needed, at a cost of about $40,000 in salary, benefits and other expenses for each navigator added. Committee members also said they should study how the marketplace can use the outreach workers and other resources to help an estimated 60,000 people who would be moved off the state’s Arkansas Works Medicaid program under changes proposed by Gov. Asa Hutchinson and endorsed by the Legislature.

The changes include limiting eligibility for Arkansas Works to adults with incomes of up to the poverty level, instead of the current 138 percent of the poverty level.

Most of those who lose Medicaid coverage as a result are expected to qualify for subsidies to help them buy private insurance on the state’s health insurance exchange. If Hutchinson’s proposals are approved by the federal government, the state Department of Human Services plans to begin moving people off Arkansas Works at a rate of about 5,000 people a month starting Jan. 1.

“We probably ought to have more of a plan than just saying we’ve hired navigators,” Mike Castleberry, a committee member and chairman of the marketplace’s board, said Wednesday.

Marketplace spokesman Alicia McCoy said the agency also has allocated $1.25 million toward a marketing campaign, aimed at encouraging enrollment, that likely will include radio and television commercials and the use of social media outlets. About 343,000 people are covered by plans on Arkansas’ exchange for individual consumers. That includes about 286,000 whose premiums are paid by state and federal Medicaid funds under the Arkansas Works program and 57,000 in non-Medicaid plans.

While people who qualify for Medicaid can sign up at any time, enrollment for others is limited mostly to annual open-enrollment periods. Open enrollment for 2018 coverage starts Nov. 1 and ends Dec. 15. Created by the Legislature in 2013, the marketplace certifies the plans sold on the state’s exchanges and helps people enroll. The 2010 Patient Protection and Affordable Care Act requires exchanges to have navigator programs.

Money for the Arkansas navigators comes from a fee, equal to 3 percent of the premiums for non-Medicaid plans sold on the exchange, that the marketplace collects from insurers. Enroll the Ridge was the only bidder that responded to a July 17 solicitation by the marketplace.

The nonprofit would employ two navigators itself and supply the others under subcontracts with Future Builders, the Hispanic Women’s Organization of Arkansas in Springdale, the Planting a Seed Foundation in Camden and the Tri County Rural Health Network in Helena-West Helena. Each navigator would be paid $13.50 an hour. Money from the contract also would pay the program manager’s wages at a rate of $25 per hour.

An additional $16,500 would go to groups that organize meetings where navigators can help people enroll.

Other money would pay for phones, computers, Internet service and rent for “support center” near St. Bernards Regional Medical Center in Jonesboro where navigators help people enroll and answer calls from consumers.

The committee’s recommendation will go to the full 11-member board on Aug. 23.

Committee member Marquita Little, health care policy director for Arkansas Advocates for Children and Families, said she is concerned that the state’s outreach efforts have continued to shrink since enrollment on the exchange started in 2013, but added that “we have seen good work” from Enroll the Ridge and its subcontractors.