The state Department of Human Services expects to submit a request in August for a federal waiver allowing Arkansas to use federal money to buy private insurance for thousands of the state’s working poor, DHS Director John Selig said Thursday.
Selig and other state officials gave lawmakers an update on the so-called "private option" for expanding health care coverage during a joint meeting of the House and Senate committees on public health, welfare and labor. It was the first time the committees had met since the end of this year’s legislative session, during which legislators approved the plan.
The federal Affordable Care Act of 2010 proposes that states expand their state Medicaid rolls to cover people earning up to 138 percent of the federal poverty level, with the federal government paying the entire cost of expansion for three years, after which state’s share of the cost would gradually increase to 10 percent.
Arkansas instead is seeking to use the federal money to pay for its working poor to buy private health insurance through the state health exchange, a marketplace where people and small businesses will shop for plans that suit their needs. The private option has received informal approval from federal officials but still requires formal approval of a waiver request.
"In August is when we anticipate actually submitting the document to (the federal Centers for Medicare & Medicaid Services), with the hope that we’ll get approval back by Oct. 1, because Oct. 1 is when … we can start enrolling people in these plans for coverage that begins Jan. 1," Selig told lawmakers Thursday.
Cindy Crone, director of health insurance exchange planning for the state Insurance Department, said the state is in the process of contracting with 30 organizations — three of them government-based and the others non-government-based — that will provide workers known as guides to help consumers enroll in insurance plans through the exchange. The state will use federal money to award the contracts and expects about 637 guides to be hired at $12 an hour, she said.
Guides are one of four types of assisters who will help people use the exchange. The others are navigators, who will be hired by the federal government; certified application counselors, who will be employees of entities such as hospitals, community health centers or consumer nonprofit organizations; and insurance agents or brokers.
The assisters are required under the Affordable Care Act and would be needed with or without the private option.
Training for all four groups of assisters will be provided through the state’s two-year colleges and will begin in mid-June. Federal grants will fund the training.
"It’s a Herculean task in a short time frame" to have the assisters ready to help people begin enrolling in the exchange in October, Crone said.
Meanwhile, the Insurance Department is working on the requirements for insurance providers that will offer plans through the exchange, Crone said. Participation in the exchange by private insurers is voluntary.
"We think we could have six to eight (insurance providers). We know we have that many who have shown an active interest," Crone said.
The deadline for letters of intent from insurance providers is June 3, and the deadline for full applications is the end of June.
"What this means for the department is a really hard July, because another hard deadline is that we must approve the plans and get our approval to the federal government by July 31," she said.
Some legislators questioned whether the guides’ efforts to reach out to Arkansans about the insurance exchange would go smoothly.
"Y’all know Arkansas as well as me," said Rep. John Burris, R-Harrison, chairman of the House panel on public health. "Six hundred people walking around with clipboards asking for Social (Security numbers)? I just see it going on borderline disaster in a lot of ways."
"I hope we can gain your confidence as we go forward," Crone said.