U.S. OKs state’s health-exchange partnership plan

Arkansas 2nd in nation with setup

Friday, January 4, 2013

— Arkansas’ plan to partner with the federal government on its insurance exchange received a green light Thursday from the federal government, making it just one of two states so far to adopt a hybrid model.


RELATED ARTICLE

http://www.arkansas…">Study sees new cash, jobs from health law, Medicaid

The conditional approval given to the state from the U.S. Department of Health and Human Services was expected, but the news was nonetheless welcomed by the state’s Insurance Department.

“We felt pretty confident. The official word makes us very happy for our Arkansas consumers,” said Jay Bradford, the state’s insurance commissioner. “It’s going to be apparent that this will be the best for Arkansans as far as taking care of their interests.”

Delaware is the other state pursuing a partnership model. In all, 19 states and the District of Columbia have received federal approval for partnership or state-run exchanges, according to the Department of Health and Human Services. The deadline for other states to decide whether they want to partner with the federal government is Feb. 15.

“No matter what states that Americans live in, they’ll soon have better health-care options,” said Kathleen Sebelius, the Health and Human Services secretary, in a conference call with reporters.

The insurance exchanges are designed to be competitive marketplaces where mostly uninsured people can shop for coverage, either online or with the help of consumer guides. The Insurance Department thinks that about 211,000 Arkansans will be eligible for coverage under the exchange. States can choose to operate exchanges completely on their own, as 17 states have done, enter into a partnership or let the federal government operate the exchange on its own.

The partnership model allows Arkansas more control over what types of insurance plans are offered on the exchange. It also provides increased latitude for making people aware of the exchange and enrolling eligible state residents.

In December, lawmakers approved an $18.6 million federal grant designed to complete the process of setting up the state’s exchange, which will begin enrollment Oct. 1. Coverage will begin Jan. 1, 2014.

Republicans killed attempts to create a state run exchange in 2011. In November, when the federal government pushed back a deadline for states to indicate whether they wanted to set up state-run exchanges - which would reserve greater state control - Gov. Mike Beebe said he would be open to reconsidering a state-run exchange. But Republicans showed no interest in the idea, and the state submitted its plan for a partnership model in December.

GOP opposition to this crucial part of the federal Patient Protection and Affordable Care Act, the health-care law championed by President Barack Obama, remains strong. At a December legislative meeting, the federal grant won approval on a voice vote over Republican opposition.

Rep. David Meeks, a Conway Republican, said he is considering introducing a resolution aimed at protesting the exchange. A resolution doesn’t have the force of law, he said, but he wants to protest federal “overreaching” in the state’s affairs. He characterized his opposition as a “state’s sovereignty” issue.

Meeks said he was concerned about the cost of running an exchange. Last month, exchange officials estimated that the partnership model - funded by a 6 percent premium fee - would not only pay for itself but also would raise about $25 million for state coffers. But Meeks remains skeptical.

“That’s all well and good. It may start out that way, but I think it’s going to end up looking a lot like Medicaid, where we have a deficit and can’t do anything without federal approval,” he said.

Rep. Reginald Murdock, a Marianna Democrat, said Meeks’ position isn’t surprising.

“That move is consistent with what you’ve heard from the other side since [the Affordable Care Act] was upheld by the Supreme Court. I hate to say it, but we’re in that kind of environment. Hopefully, we don’t play politics with it and better minds will prevail,” Murdock said.

Republicans will control the House and Senate in the legislative session to begin Jan. 14.

The conditional approval issued Thursday is contingent on Arkansas continuing to perform activities outlined in its application.So far, Arkansas has met all its deadlines, said Cynthia Crone, the exchange’s planning director.

“We’ve been working toward it as if we would achieve it,” Crone said.

Remaining unfinished is hiring and training about 550 “guides,” or consumer assistance personnel, who will find and enroll eligible Arkansans. The Insurance Department also will develop methods to evaluate what insurance plans can be offered on the exchange.

“We should make all the deadlines,” Crone said.

As yet unresolved is what power - if any - the federal government retains under the partnership model to ensure that all Arkansans have access to coverage on the exchange. In August, the exchange’s plan-management committee voted against requiring insurance companies to offer exchange polices in every county. That raised fears among consumer advocates that poor, rural counties might have few if any exchange options.

During the conference call Thursday, Sebelius and other Department of Health and Human Services officials referred a question from the Arkansas Democrat-Gazette about statewide access to their press office. The press office did not immediately respond to a request for comment.

Exchange officials are currently studying what kind of regional coverage might be offered to protect against companies “cherry-picking” the more affluent areas of the state. No decisions have been made, Crone said.

Bradford said he wants as many out-of-state companies to enter the Arkansas market as possible. A statewide access requirement might discourage that, he said.

“It might turn off companies coming to Arkansas. I’m not going to be so hard nosed about every county so there will be a lot more players,” Bradford said. “If Aetna comes in for 70 counties rather than 75, I’ll probably dance to that tune.”

Front Section, Pages 1 on 01/04/2013