Although it’s still unclear exactly what shape Arkansas’ health-insurance exchange will take before enrollment starts next October, an advisory committee said Thursday that new state lawmakers need to be quickly brought up to speed about the status of the private marketplace where an estimated 500,000 uninsured Arkansans can shop forcoverage.

Gov. Mike Beebe hasn’t yet met with any legislators to discuss whether Arkansas should take advantage of an extended federal deadline to decide if it should switch from its current federal partnership to a state-run exchange, said Jennifer Flinn, his deputy policy director, at a meeting of the exchange’s steering committee.

The state needs to alertWashington, D.C., by Dec. 14 if it wants to pursue a state-run exchange.

If the state does decide to set up a state exchange, it would likely cost more initially, but it ultimately would save money for consumers since they wouldn’t have to pay a 4 percent federal premium that will be charged to states that choose to let the federal government run their exchanges. The fee would also apply tostates like Arkansas that form a federal partnership.

The initial upfront costs would be associated with contracting with private companies to set up much of the infrastructure of the exchange, said Cynthia Crone, the exchange’s health-benefits planning director.

“You would almost have to buy something out of the box,” said Anna Strong, director of health-care policy for Arkansas Advocates for Children and Families and a member of the committee.

The Patient Protection and Affordable Care Act, the health-care law championed by President Barack Obama, left up to the states how to structure their exchanges. The state Legislature killed a move to create a state exchange in 2011.

If state lawmakers decide to switch to a state-run exchange - an option favored by Beebe - Arkansas would have to convince the federal government by the December deadline that it has already planned its consumer outreach and plan management components under the partnership model, and provide a timeline on how it would complete the other parts of a state exchange, Crone said.

Since the Nov. 6 election,federal regulations have been coming more frequently, filling out the picture of how exchanges across the country will operate when they open on Jan. 1, 2014, Crone said.

One new rule from Washington, D.C., indicates that the federal government will subsidize a portion of insurance premiums to cover the cost of in-vitro fertilization treatments. In September, state Insurance Commissioner Jay Bradford adopted benchmark health benefits, as required by the Affordable Care Act, but they didn’t include in-vitro, a mandated benefit for mostArkansas insurance plans under a 1987 state law. The new federal rule says Washington will foot the bill, Crone said.

At the time, Bradford’s decision was estimated to cost the state up to $3.8 million because the federal government penalized states for not including a state-mandated benefit in the benchmark health benefits to be offered on the exchange. The new federal rule appears to make it a moot issue, Crone said, although the Insurance Department is waiting for further guidance from the federal government.

Fertility advocates had worried that repealing the state mandate for in-vitro treatments would have made insurance coverage prohibitively expensive or simply unavailable in the state.

Committee members also discussed how to dispel misinformation about the exchange and better educate the public, especially dozens of new lawmakers who will arrive in Little Rock in January for the legislative session.

Herb Sanderson, associate state director for AARP, suggested a “little health-care university to get some factual information” to new members.

“We need to educate decision-makers.... This is tough stuff,” said Dr. Drew Kumpuris, a cardiologist at St. Vincent Heart Clinic and a committee member.

Crone said that exchange officials have tried to dispel odd rumors about the exchange for months. One recent myth making the rounds in Arkansas, she said, was that you would be required to have a “chip” installed in your body if you bought insurance on the exchange.

Northwest Arkansas, Pages 11 on 11/30/2012