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Arkansas Health Officials Answer Questions About New Insurance Marketplace

Health Care Forum
Jack Heinritz
/
KARN

A partial federal government shutdown will not delay efforts to implement Arkansas’s Health Insurance Marketplace, according to state health officials. 

On Tuesday, open enrollment begins for the new online Marketplace and Arkansans will have an opportunity to view and compare different insurance plans, set up a Marketplace account, and buy a plan that best suits their needs. 

During an event at the University of Arkansas Clinton School of Public Service, Dr. Joe Thompson, the state’s Surgeon General, said people who already have insurance coverage from an employer face two restrictions if they are interested in changing plans.

“Your employer must offer minimum essential health coverage and it has to be affordable, or cost you no more than nine percent of your family’s annual income. The aforementioned two things have to be violated for you to be able to go to the Marketplace and get a tax credit,” said Thompson. “If that is not the case, you can still go to the Marketplace, but you won’t get a tax credit to help supplement your insurance purchase on the Marketplace and your employer is not going to let you take his or her contribution to your insurance coverage with you to buy on the Marketplace. It is still the best deal, usually through your employer, if you’re offered the minimum essential benefit and the employer is putting money in to help you pay for it.”

Last week, Arkansas became the first state to win federal approval to use Medicaid funds to purchase private insurance for thousands of low-income residents under the federal health care law.

Cindy Crone, a certified nurse practitioner, serves as Insurance Deputy Commissioner for the online Marketplace, known as the Arkansas Health Connector.

“Having the private option is so important for consumers because it means that as people’s income changes, which it does and will particularly change now that we’re at this cut of 138 percent of the poverty level; they can still keep their same provider network, they can keep the same health care plan, and they don’t have to move… just the payer-mix changes,” Crone said. “All of this will help Arkansans have continuity of care and our health care facilities will stay open.”   

Dr. Andy Allison is Medicaid Director with the Arkansas Department of Human Services. He says there is a sliding scale and family income will determine the tax credit.

“For a family of one, 138 percent of poverty is around $15,500 and then with additional children the amounts would go up. A family of four is about $32,000, so compared to the price of a full family insurance premium, which is $1,200 or $1,400 a month… you’re looking at a meaningful percentage of pay,” Allison said.

Before creation of the online Marketplace, Dr. Thompson said the state’s health care system was on the verge of collapse, because 25 percent of Arkansans between the ages of 19 and 64 did not have health insurance coverage.

October 1st is the first day that the aforementioned 25 percent has a chance to get covered.

“Another important day is December 15th because coverage starts on January 1st. December 15th is important so that we maximize and optimize people’s coverage. March 31st is the last day people can signup for this year so we are trying to get coverage for as many of the 550,000 uninsured Arkansans who don’t have it” Thompson said.

Andy Allison admits more work still needs to be done to help residents understand the costs and benefits of enrolling early.

“For people above 138 percent of poverty, enrollment is not immediate. However, costs are incurred immediately upon the onset of some acute or high-cost event,” said Allison. “We have a tremendous communication challenge so that citizens understand the costs involved in the health care system, how to avoid those costs, how to be personally responsible, and how to take advantage of certain benefits,” Allison said.

Health officials say coverage provided by the new plans will ultimately benefit all Arkansans.

“We’ve talked about what’s in it for low-income people, or people under 400 percent of the federal poverty level, which is most Arkansans because 75 percent or more hit that threshold,” said Cindy Crone. “All of us above that threshold will be helped by this Marketplace, because on average we’re paying about $1,500 a year more in insurance premiums to help pay for those who have no coverage… to pay for uncompensated care. As people get healthier and everybody gets in, the costs for everyone including the full pay will go down as well.”   

Though state lawmakers have rejected a plan to use $4.5 million in federal funds to promote Arkansas’s new Health Insurance Marketplace through media advertisements and direct mail, state health officials are encouraging residents to visit the following websites for more information on insurance plans. 

Click here: Arkansas Health Connector

Click here: The Federal Health Insurance Marketplace

Malcolm Glover was a news anchor/ reporter for KUAR News from 2007- 2014.