After just two weeks of enrollment, the Arkansas Department of Human Services announced today that 56,288 adults have informed DHS that they wish to enroll in the “private option” program; nearly all of them are now enrolled. That already puts DHS about a quarter of the way toward the total number of people projected to be in the program, which uses Medicaid funds via the federal Affordable Care Act to pay for private health insurance plans for low-income Arkansans on the Health Insurance Marketplace.
First, a word on how enrollment works in the “private option.” First, folks fill out an application expressing that they want to enroll in the “private option” and DHS checks to see if they qualify — only people whose household income is equal or less than 138 percent of the federal poverty level qualify ($15,856 for an individual, $32,499 for a family of four). If they do, DHS sends a letter to the applicant telling them to proceed to a Insure Ark, a state-run website where applicants can select a plan. This site is different than the federal portal where people above 138 percent FPL shop, and unlike the federal portal, which has been slammed with major glitches, the state site is running smoothly. (Kind of makes you wish Arkansas had gone with a state-run exchange!)
If enrollees proceed to Insure Ark, they will be screened to determine whether they are medically needy and would be best served in the traditional Medicaid program. If deemed medically needy, they’ll be enrolled in Medicaid; if not, they’ll select a private plan.
But even if enrollees do not proceed to the website and select a plan, they have still enrolled — their initial application has been approved. If enrollees fail to select a plan, a plan will be automatically selected for them via the “private option” auto-assignment policy, which seeks to balance market share between carriers (see more here). Consumers will be informed of their new plan and have 30 days to select a new plan instead of the one chosen by auto-assignment if they like.
Got all that? Here’s a look at the people filling out applications and enrolling:
*The overwhelming majority of them — 53,660 — communicated with DHS via their wildly successful direct mail campaign. These people, all current DHS clients, have all enrolled in the “private option” because they’ve mailed a signed application statement to DHS and DHS has already confirmed their income status via existing information. DHS has sent them a letter directing them to the Insure Ark site to pick a plan. More than 10,000 of them have already done so; those that don’t will be auto-assigned.
*In addition to Insure Ark, which exists solely for those eligible to pick a plan, the state-run web portal Access Arkansas allows Arkansans who wish to apply to the “private option” to begin the application process. This web site is also running smoothly (though DHS suggests going to the federal portal to apply unless directly contacted by DHS). DHS has received 1,509 completed applications through the web portal. They will now verify the incomes of these applicants; if they qualify, they will be enrolled and directed to the Insure Ark site to get the “medically needy” screening and pick a plan (or be auto-assigned if they don’t follow through). If they do not qualify, they will be directed to the federal portal to shop on the Health Insurance Marketplace.
*DHS has also received 1,119 completed telephone and paper applications. Same as above — DHS will verify income and if they qualify, they’ll be enrolled and be directed to Insure Ark to get the medically needy screening and shop for a plan.
*Of the 53,660 who have been enrolled, 10,454 have thus far completed the process by going to Insure Ark. Of those, 2,973 were found to be medically needy and will be enrolled in the traditional Medicaid program. The rest selected a private health insurance plan.
*DHS does not know how many people who qualify for the “private option” have applied through the federal portal. Those numbers have been held close to the vest by the feds but are generally assumed to be small given the extreme problems with the federal site. In theory, DHS will be informed about people who complete an application on the federal site but are below 138 percent FPL and thus qualify for the “private option.” DHS spokesperson Amy Webb said the agency has not thus far been contacted about anyone applying through the federal portal.