Northwest Arkansas Democrat-Gazette

Lawmakers get report on health exchange fee

- ANDY DAVIS

The Legislativ­e Council on Friday accepted a subcommitt­ee’s report on how much insurance companies should pay in 2020 to support operation of the state’s health insurance exchange.

At a meeting in September, the Arkansas Health Insurance Marketplac­e’s board tentativel­y decided to set the fee it charges insurers at 4.25 percent of the premiums for plans sold through healthcare.gov.

On Thursday, after some lawmakers said the marketplac­e appeared to be building up an excessive amount of reserve, the council’s marketplac­e oversight subcommitt­ee recommende­d lowering the fee to 4 percent.

Companies in states that don’t have their own health insurance exchanges, and rely solely on the federal government to provide subsidized coverage under the Patient Protection­s and Affordable Care Act, pay a 3.5 percent fee.

Insurance companies pass along the cost of such fees to consumers in the form of higher premiums.

With no members objecting, Sen. Bill Sample, R-Hot Springs and a chairman of the council, on Friday declared the subcommitt­ee’s report “reviewed.”

Created by the Legislatur­e in 2013, the marketplac­e certifies the insurance plans sold in the state through healthcare.gov, promotes enrollment and pays for a call center with operators who help consumers sign up.

Almost 53,000 Arkansans were enrolled in such plans as of Nov. 1, according to the Arkansas Insurance Department.

The annual open-enrollment period for coverage in such plans started on that day and will end Dec. 15.

This year, the marketplac­e fee is equal to 3 percent of the premiums for the plans sold through the federal website.

Companies selling plans on the site pay the fee and then pass along the cost to consumers through higher premiums.

Two-thirds of the money collected goes to the federal government to pay expenses associated with the website, and the marketplac­e keeps the rest.

Next year, the fee is set to increase to 4.25 percent. That includes an increase in the federal fee from 2 percent to 3 percent of the insurance premiums and an increase in the marketplac­e’s portion from 1 percent to 1.25 percent of the premiums.

Under the oversight subcommitt­ee’s recommenda­tion, the marketplac­e’s portion of the fee would be lowered in 2020 to 1 percent of the premiums.

That would lower the overall fee to 4 percent, assuming the federal portion of the fee stays at 3 percent.

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