LITTLE ROCK — Requiring dental and vision coverage under Arkansas’ so-called private option would increase costs by $42.6 million a year, or about $20 per person per month, according to a report presented to a legislative panel Thursday.
The report was presented to the House and Senate committees on public health, welfare and labor. State Department of Human Services Director John Selig told reporters after the meeting the agency was only providing requested information and has no plans add dental and vision benefits to the private option.
Selig said state officials would seek to add the coverage if the Legislature directs them to do so, but the federal government would not allow additions to plans before 2016.
“We wouldn’t want to add it now until we’re sure that we’re going to meet the cost neutrality piece,” Selig said, referring to a spending cap that the state is required to stay within during the program’s first three years or be responsible for paying any overage to the federal government.
The private option is Arkansas’ program that uses federal Medicaid money to subsidize private health insurance for people earning up to 138 percent of the federal poverty level. By the end of June, 184,807 people had been found eligible for the program, according to DHS.
Currently, one company, Centene — operating in the state under the name Ambetter Arkansas — is providing dental and vision coverage to some people under the private option.
DHS officials have said they did not intend for dental and vision coverage to be part of the private option and that starting Jan. 1, 2015, plans offered through the program will be limited to what the federal Affordable Care Act classifies as essential health benefits — which for adults do not include dental or vision benefits.
Sen. Linda Chesterfield, D-Little Rock, said during Thursday’s meeting she was puzzled that dental and vision care is provided under Medicaid for children up to age 18 but is not considered essential for adults ensured under the private option.
Chesterfield asked how medical complications resulting from lack of dental care would be handled.
“A complication, perhaps, or even the need for antibiotics, a prescription drug to treat (a complication), would be a covered service,” said Deputy Insurance Commissioner Cynthia Crone.
Rep. David Meeks, R-Conway, said a number of dental clinics in the state serve low-income people.
“We ought to encourage private-sector interest to take care of the poor rather than I guess using the easy way out and trying to pile on with government,” he said.
Sen. Stephanie Flowers, D-Pine Bluff, said she was concerned that Ambetter’s benefits for restorative dental services require a six-month wait, so a person who obtains a plan with dental benefits now would not be able to receive those benefits before they end Jan. 1.
Crone said a warning about the waiting period and the upcoming end of dental benefits has been posted on the insureark.org website, which people use to pick plans under the private option. Flowers questioned whether that was enough.
“What pops up in my mind is deceptive trade,” Flowers said.
Also Thursday, state Surgeon General Joe Thompson told the panel that proposed language on health independence accounts should be ready to release for public comments in August. Under the proposal, people covered under the private option would be able to make contributions to accounts that they could later use to buy private insurance if they leave the private option.
“We’re in, I would say, intense dialogue with the feds on the placement of independence accounts,” Thompson said.
A number of people in the audience were there for discussion of the federal Community First Choice Option program, which allows states to use Medicaid money to provide home- and community-based services to the disabled.
Sen. Cecile Bledsoe, R-Rogers, chairman of the Senate public health committee, said she had removed the item from the agenda because supporters and opponents wanted to argue their sides and “I cannot see how presenting both sides without a way to discern who is right would help us at this time.”
After Rep. Andy Mayberry, R-Hensley, and several other members objected to dropping the item, the committee referred it to a subcommittee of which Mayberry is chairman.