17,090 more put on Medicaid rolls in May

More than 17,000 Arkansans were approved for coverage under the state's expanded Medicaid program in May, raising the total to more than 187,000, the Arkansas Department of Human Services announced Thursday.

Meanwhile, the cost of covering enrollees under the so-called private option continued to drop slightly, with the department paying insurance companies an average of $487.16 per enrollee for this month, compared with $490.19 last month.

Department spokesman Amy Webb said those who have enrolled in recent months have tended to be younger, leading to lower premium costs.

But the cost remains above the monthly limit of $477.63 per enrollee set in a federal waiver that authorized the program.

The Human Services Department still expects the average age to be above projections, meaning the department still plans to ask for the spending limit to be increased.

Approved by the Legislature last year, the expansion of Arkansas' Medicaid program extended eligibility to adults with incomes of up to 138 percent of the poverty level -- $16,105 for an individual or $32,913 for a family of four.

Those approved for coverage as of May 31 included 152,112 enrolled in the private option, which provides coverage through plans offered on Arkansas' federally run health insurance exchange with Medicaid paying the premium and providing additional subsidies to reduce or eliminate any required out-of-pocket spending for medical care.

An additional 20,205 enrollees had been assigned to the traditional Medicaid program because their health needs were considered exceptional, and 14,806 applicants had been determined eligible but had not yet completed enrollment.

The 17,090 people who were approved for coverage in May marked an increase from a month earlier, when 14,466 Arkansans were approved.

The figures indicate that almost three-fourths of the 250,000 Arkansans estimated to be eligible for coverage under the program had applied and been approved as of May 31.

Enrollment began Oct. 1 for coverage that started in January.

"It really has not slowed down a great deal, even six months into it," Webb said. "We're continuing to see a lot of interest."

However, the new total includes 4,798 people who were notified last month that their coverage would end after May 31 because their eligibility had not been verified.

Webb has said those who received notices had applied through a federal enrollment portal, healthcare.gov.

The federal Centers for Medicare and Medicaid Services sent Arkansas information on the applicants in a data file with code indicating that their eligibility had not yet been verified, but state Human Services Department employees didn't know about the code and thought the applications had been approved.

As of Thursday, Webb said 132 of those who received notices have had their eligibility verified after reapplying through a state website, access.arkansas.gov.

In addition, the eligibility of nine enrollees was verified after they supplied additional information to the Centers for Medicare and Medicaid Services, she said.

More enrollees could have their coverage reinstated as the Human Services Department processes additional applications submitted through the federal website, Webb said.

"Out of an abundance of caution, we're just doing it a little slower, checking all of the coding, making sure we understand it and it's accurate so we don't get into this situation in the future," Webb said.

For most people who do not qualify for Medicaid, enrollment on the state's insurance exchange ended March 31. But those who received the notices can apply immediately for re-enrollment.

Max Greenwood, a spokesman for Arkansas Blue Cross and Blue Shield, said coverage can start retroactive to June 1 for enrollees who chose to pay premiums for June and July at the same time.

In addition to the payments to insurance companies, the cost of the private option also includes payments for benefits that are required by federal Medicaid rules but not provided by the private plans.

Those benefits include nonemergency medical transportation and vision and dental benefits for 19- and 20-year-olds. The state had projected those "wraparound benefits" would cost $8.58 per enrollee each month.

Andy Allison, who stepped down as Medicaid director effective June 1, said in April that those costs had been lower than projected -- about $6.50 per month.

Under the terms of the waiver from the Centers for Medicare and Medicaid Services, the federal government will pay the full cost of providing coverage under the private option as long as the state's spending is below the cap. If the spending exceeds the cap, the state will owe the difference to the federal government at the end of a three-year demonstration period.

However, the waiver allows the state to request an adjustment in the cap if it has information indicating that its projections "may underestimate the actual costs."

Sen. David Sanders, R-Little Rock, a sponsor of the legislation creating the private option, said the drop in costs is "precisely what we outlined two months ago, in that we probably had hit our maximum amount and you're seeing the age drop."

He said he expects planned changes in the program to help lower the cost even more. Those include creating health savings accounts for enrollees, changing how the state provides nonemergency medical transportation for enrollees and requiring more enrollees to contribute toward the cost of their medical care.

In addition, he said the state could consider further changes to the program based on Medicaid waivers that have been granted to other states.

"We're not pouring concrete on policy; we're molding clay," Sanders said.

Senate President Pro Tempore Michael Lamoureux, R-Russellville, said Wednesday that the program faces an uncertain future in the Legislature next year after Rep. John Burris of Harrison, another architect of the program, lost a runoff in the Republican primary to private option foe Scott Flippo of Mountain Home.

Continued funding for the program requires the approval of 27 members of the 35-member Senate and 75 members of the 100-member House.

During this year's fiscal session, authorization for the funding passed 27-8 in the Senate and 76-24 in the House.

Rep. David Meeks, R-Conway, who voted against the appropriation, said Thursday that he still opposes the program in its current form but would support keeping some assistance for people with incomes up to the poverty level.

"Based on the election that we just saw, I think you'll either see some major reform in the private option, or you will see it scratched completely and something else take its place," Meeks said.

A Section on 06/13/2014

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