Private Option insured 94,000 by end of February

Members of the Fort Smith Regional Chamber of Commerce received an update Friday morning (March 7) on the current state of the so-called Private Option, Arkansas' answer to the Affordable Care Act (aka Obamacare), where money that would be spent on Medicaid coverage for poor Arkansans is instead used to purchase private insurance for individuals generally earning less than $15,000 per year.

According to Craig Wilson of the Arkansas Center for Health Improvement, before implementation of the private option, more than 400,000 Arkansans were living without healthcare. And according to Wilson, the years and even decades before the implementation of the Obamacare at the federal level and passing the Private Option legislation in the state's General Assembly had left many people with high premiums, cuts in services and spending caps on their insurance policies, which were becoming more and more expensive with time.

He said overall, the goals of Obamacare were good but hard to implement all at once. Those goals included improving the quality of care and access to care while reducing costs.

Due to the way the federal legislation was crafted, Wilson said many Arkansans qualified for some level of subsidy to assist with costs under Obamacare, which allows individuals to obtain coverage assistance even if their income is up to 400% of poverty level. The Private Option maxes out at 138%, he said.

But he said while many individuals may have been opposed to Obamacare, he said it would be hard to show that Arkansas' Private Option was not a good alternative. He highlighted two specific reasons why it was necessary for Arkansas to have taken the lead nationally in the creation of the Private Option, which is now being looked at by several states as a model for providing health care to its citizens.

"The cost of care for others when they show up at the emergency room and don't get the preventative care that they need prior to that … that's what costs. It's not the uninsured are not accessing care, they were just accessing it in the most inefficient way possible by showing up at the emergency room," he said, before highlighting the numerous delays in the full implementation of the federal healthcare legislation. "So because of the issues that we had before and because of the changes and delays in the Affordable Care Act, we know that we must take the reigns as a state and do something for our citizens to meet their healthcare needs."

Wilson said making private insurance available to the hundreds of thousands of Arkansans who are likely eligible for coverage under the Private Option would save those individuals and taxpayers at large bundles of money as this program not only provides coverage, but also "teaches (people) how to use insurance effectively."

He also said the Private Option is fully funded by the federal government through the year 2016, which gives Arkansas time to implement the program at virtually no cost to the state's taxpayers.

As a whole, Wilson asserted that the Private Option is reforming the healthcare model in the state of Arkansas and will ultimately have a positive impact on individuals, businesses and the economy. He said the program was digitizing much of the medical records in the state through mandated requirements and was opening coverage to a variety of different insurance providers who previously had not been in the Arkansas marketplace.

In all, he said there was nothing Arkansas could have done to keep the Affordable Care Act from becoming law and by making significant changes to the program through state legislation, the state economy would recapture as much as $1.1 billion worth of money that had been going out of state.

Already, as of late February, Wilson said 26,000 people had enrolled in the Health Insurance Marketplace and "had been transmitted to the (health) insurance carriers."

Regarding the Private Option, Wilson said there had been more than 190,000 applications by late February, which he said "demonstrates the need that was out there." Of those that applied, he said 127,000 had been determined eligible for the Private Option. Of those, about 11,500 were determined to be better served by Medicare due to having serious medical conditions while another 94,000 of the eligible individuals have been enrolled in private insurance, well more than a third of what Wilson said was anticipated.

"We're very much nearing the halfway mark, and getting over the halfway mark, in terms in meeting the expectations for enrollment. And what that means when you look at both the Private Option and those individuals who are receiving subsidies through the Health Insurance Marketplace, that's about 130,000 individuals that received coverage in the private marketplace. That money is turning over in the private market and those people are getting coverage, they're getting care."