State surgeon general holds public meeting on private option


The Arkansas Surgeon General gave a briefing Friday in Pine Bluff on a trio of new requirements for state residents insured under the so-called private option.

Dr. Joseph W. Thompson said that the hearing — held at Jefferson Regional Medical Center — was the second of two such public meetings required by federal regulations to ensure that state residents are made aware of the changes approved by the Arkansas State Legislature as part of their 2014 renewal of private option funding.

Thompson, who is also director of the Arkansas Center for Health Improvement, said that the changes include the creation of health savings accounts, known as Independence Accounts, which will affect those enrollees at 50 percent or more of the federal poverty level and above.

“The goals of the Independence Accounts are for the enrollees to gain knowledge and experience in managing their participation in the health care system,” Thompson said. “It enables enrollees to take personal responsibility for their health care and to accrue funds to offset the costs of their premiums.”

The second change involves cost sharing, which — pending a waiver from federal Medicaid officials — will allow private option enrollees to make a total of six modest payments that will go into a rollover fund that can then be used to help offset the cost of private market premiums once an individual’s income level rises above the point where they can be a private option participant.

“Cost sharing will allow private option participants to gain experience in paying for health care at the point of service and to help them understand personal responsibility,” Thompson said.

Finally, Thompson said that the state legislature wants to contain costs by limiting the number of non-emergency medical transportation trips to eight per year for people who are not medically frail.

Thompson said that no limits for non-emergency medical transport will be imposed on those classified as medically frail.

The Pine Bluff meeting was sparsely attended, with less than 10 people in the audience, and most of them were helping put on the presentation. It was the last of the public meetings scheduled. Public comments also can be submitted by mail or online at www.medicaid.state.ar.us.

The plan for the proposed changes must be submitted to the U.S. Centers for Medicare and Medicaid Services no later than Sept. 15 and must be approved and implemented no later than Feb. 1 to meet the requirements of the state law that created the private option. The law calls for the program to end if the federal government does not approve all of the changes the state seeks.

The program also will need a new appropriation of federal funds next year to continue, which will require a three-fourths vote in both chambers of the Legislature.

“I believe that the lack of public comment on this issue tonight reflects upon the popularity of this program,” Thompson said after the meeting. “We now know that, due to the private option, Arkansas recorded the highest drop in uninsured residents in the nation.”

According to a Gallup report released Tuesday, the number of Arkansas uninsured fell from 22.5 percent at the end of 2013 to 12.4 percent midway through 2014, a 10.1 percentage point reduction. Kentucky ranked second with an 8.5 percentage point decline, dropping from 20.4 percent to 11.9 percent.

Thompson said that the Arkansas private option was created when the state decided to take federal Medicaid expansion dollars and use them in private health insurance exchanges to subsidize low-income workers’ health care coverage.

— Arkansas News Bureau reporter John Lyon and Stephens Media Washington D.C. Bureau reporter Peter Urban contributed to this report