Two bills that outline the framework for the Arkansas “private option” health insurance expansion plan have been amended.
The bills’ sponsors include Sens. Jonathan Dismang (R), Paul Bookout (D), and David Sanders (R) as well as Reps. John Burris (R), Bruce Westerman (R), Mark Biviano (R) and House Speaker Davy Carter (R).
The amended bill flushes out details of a shell bill and covers eight pages. It charges the Department of Human Services to:
- Maximize the available service options
- Promote accountability, personal responsibility, and transparency;
- Encourage and reward healthy outcomes and responsible choices; and
- Promote efficiencies that will deliver value to taxpayers.
DHS is also charged with securing federal waivers and approvals for the changes lawmakers want to see implemented in order to use Medicaid expansion money to subsidize health insurance for low-income workers through a forthcoming health exchange.
“The program shall include premium assistance for eligible individuals to enable their enrollment in a Qualified Health Plan through the Health Insurance Marketplace,” the bill reads.
A provision of the measure requires DHS to promote insurance coverage in the exchange for children and parents currently utilizing the ARKids First program. Populations from 0% to 17% of the federal poverty level would be included. The program would also allow for cost-sharing in certain situations.
The bill requires the Insurance Department and DHS to promulgate rules for the new law, but mandates that they present the rules to the Legislative Council no less than 30 days before recommending.
There is an outline in the bill that also highlights a 120-day reduction in the insurance program if federal medical assistance percentages fall below certain thresholds, such as below 100% of funding in the first three years or below 90% in year 2020 or after.
As was previously reported, participants eligible in the private option plan must acknowledge that it is “not a perpetual federal or state right or guaranteed entitlement” and is subject to cancellation “upon appropriate notice.”
There is a provision in the newly amended bill to test a pilot program for health savings accounts or medical savings accounts during 2015.
In an effort to make pricing of the plans in the exchange competitive, the bill calls for at least two qualified health plans to be offered in each of Arkansas’ 75 counties. It requires those companies to participate in Gov. Beebe’s Payment Improvement Initiative, which has sought to bend the cost curve on Medicaid spending by shifting from a “fee for service” model to an “episodic care” model.
A previously discussed provision to limit an insurance carrier’s market share to 65% in newly eligible populations related to Medicaid is not in the bill.