U.S. offer to state's health hub is rejected

Consumers in some states who shop for health insurance on healthcare.gov this fall will be able to choose from "standardized" options, but not Arkansans, a state board decided Wednesday.

In a voice vote, the Arkansas Health Insurance Marketplace board of directors decided to decline an offer by the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services to feature so-called Simple Choice plans on healthcare.gov.

Such plans are offered by different companies but have the same deductible, required payments for services and other features.

In states with federally run exchanges, healthcare.gov this year allowed consumers to select whether to compare only the Simple Choice plans or to look at both standard and nonstandard plans. Insurance companies were encouraged, but not required, to offer the standard options.

The Simple Choice label isn't used for plans offered to Arkansans. That's because Arkansas is among several states that use the federal website and enrollment system but establish their own criteria for the plans.

The Centers for Medicare and Medicaid Services asked such states to notify it by March 1 whether they want to use the Simple Choice label for plans that will be offered for coverage starting in 2018.

Angela Lowther, director of policy and compliance for the Arkansas Health Insurance Marketplace, said insurance companies offering plans on the Arkansas' exchange were concerned about the cost of designing the plans meeting the Simple Choice criteria.

Although the companies wouldn't be required to offer the Simple Choice plans, they want to make sure they keep the flexibility to offer nonstandard plan designs, she said.

"The carriers indicated their desire to maintain flexibility long-term," Lowther told the marketplace board.

"Hopefully our conversation with HHS down the road will allow that to happen" while also providing the simplified shopping option, Lowther said.

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This year, deductibles for Simple Choice plans range from $1,250 for gold-level plans, designed to cover 80 percent of a typical patients' medical expenses, to $6,650 for bronze-level plans, designed to cover 60 percent of such expenses.

The required co-payment for a doctor's visit ranges from $20 for the gold Simple Choice plan to $45 for the bronze plan.

Plans that are not labeled Simple Choice are also labeled bronze, silver or gold but can have different deductibles, co-payments and other features.

Health insurance exchanges, like Arkansas', were created by the 2010 Patient Protection and Affordable Care Act and allow consumers to shop for coverage and apply for subsidies to help pay for it.

As of Feb. 1, 70,374 were enrolled in non-Medicaid plans in Arkansas' exchange for individual consumers, down from 73,648 as of Feb. 1, 2016, according to the Arkansas Insurance Department.

The annual enrollment period for consumers to sign up for non-Medicaid plans for coverage starting in 2017 ended at midnight Jan. 31.

Open enrollment for coverage starting in 2018 will begin on Nov. 1 and end Jan. 31, 2018.

Metro on 02/09/2017

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