Arkansas Works cost up 14 percent per enrollee

LITTLE ROCK -- Recent state figures show the average cost per person of subsidized private health insurance under Arkansas Works increased by more than 14 percent last month.

The spike is partly due to premium increases that took effect Jan. 1, the Arkansas Democrat-Gazette reported.

Under Arkansas Works, the state uses federal and state funds to buy coverage on the Arkansas' exchange for people who qualify for Medicaid under the 2014 program expansion.

The state made payments last month to insurance companies that averaged about $578 per health enrollee, according to data provided by the state Department of Human Services. That was a 14.4 percent increase from the average $505 paid per enrollee in December.

The January cost also included an average monthly premium of $476, an increase of nearly 30 percent compared to the average premium in December. The increase reflected insurance companies' response to a decision by the Trump administration to end cost-sharing reduction payments, which compensated insurers for providing enhanced benefits to low-income consumers not qualifying for Medicaid.

Arkansas Works' cost will determine whether the state will owe money to the federal government under the terms of the waiver authorizing the program. The waiver's terms limit the cost from 2017-2021 on the basis monthly per enrollee caps, which increase annually by about 4.7 percent.

The monthly cap per enrollee this year is about $597. If the total cost over five years exceeds the limit calculated using the caps, the state will owe the difference to the federal government.

State Desk on 02/11/2018

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