Health hub panel urges slight fund­ing rise

Northwest Arkansas Democrat-Gazette - - NORTHWEST ARKANSAS - ANDY DAVIS

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.

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