If you don’t currently have health insurance, open enrollment in the Affordable Care Act (ACA) healthcare runs from Nov. 1 through Dec. 15. Enrollment for those over 65 began Oct. 15 and goes through Dec. 7. The state enrolls people in programs such as Arkansas Works and Medicaid throughout the year, but you have to meet income limits to participate in those programs.
Some Eureka Springs residents have found that taking Social Security early while continuing to work or a small raise at work can mean you no longer qualify for Arkansas Works or Medicaid. Then, instead of a Cadillac program that pays nearly all healthcare expenses, people have been left with an old clunker, insurance through the federal ACA program that has high deductibles.
Earlier this year the state instituted work requirements for those receiving coverage under the Arkansas Works Medicaid expansion program. Unless they are exempt for reasons such as being handicapped, people on Arkansas Works between the ages 30 and 49 must provide proof of 80 hours of work activities each month to keep insurance. Work activities can include working at a job that pays money. Certain hours can also be allotted for going to school, job training, volunteering, and looking for a job.
Thus far, about 8,400 people have lost coverage under the Arkansas Works program. When fully implemented, it is expected about 167,000 enrollees will be required to meet the work requirements.
It can all be very confusing, even for people who are well-educated and accustomed to government paperwork. Some local residents have found it helpful to consult with an insurance agent. One such agent who is willing to help is Dave Teigen of Teigen Insurance.
Teigen said most of his clients who are receiving coverage under Arkansas Works are outside the ages required to report hours of work activities.
“I have had very few customers lose coverage because of not complying with the income reporting requirement,” Teigen said.
While Medicaid and Arkansas Works programs have been a literal lifesaver for many, there are concerns about sustainability of the programs.
“One of the big problems is funding for this program,” Teigen said. “I am not sure exactly how that is going to work at the state level as far as additional funding. As I understand, the funding for the state Medicaid expansions was paid for by the federal government for a four-year period that’s ending at the end of this year. I do think that state funding is going to be problematic for the Arkansas Works program as it is currently structured.”
Teigen assists a lot of his clientele in logging on to their online accounts with Arkansas Works.
“I do know the website has been up and down quite a bit,” Teigen said. “Recently I had trouble for two days logging into the portal to comply the work requirements. The Department of Human Services (DHS) changed the portal they used, and switched to a new system. Ever since they have done that, it has been more difficult for access from our side. But my clients have been able to get through to get their work requirements logged in.”
If people have difficulty navigating the website on their own, Teigen recommends they take proof of income from working to the DHS office in Berryville. He had high praise for the staff there.
“That team at the Berryville DHS office is phenomenal,” Teigen said. “They have helped me thousands of times over the past four years.”
Anyone who changes their address needs to be sure to give their new address to DHS immediately. Teigen said if DHS gets any piece of returned mail, the person is automatically disqualified for coverage.
“I’ve had that happen and sent letters, income statements, and changes of address,” Teigen said. “I’m happy to help people. It can be difficult for people to know what they have to do. I am open to helping as many people in the Arkansas Works program as is humanly possible.”
Teigen doesn’t charge anything for his services. If he gets people coverage, private insurance companies pay him a fee.
“Healthcare is something we can’t mess with,” Teigen said. “Unfortunately, it has been made fairly confusing as far the requirements to have coverage and the different options available to people.”
People can make too much to qualify for Arkansas Works or traditional Medicaid. Teigen said if you are making more than about $16,200 on an annual basis, you will be disqualified by income. When you get that disqualification notice, you would need to go through the federal Affordable Care Act site to get squared away.
If you get a notice that your coverage officially ended as of a certain date, that letter will create what is known as a special enrollment period and allow you to enroll outside the open enrollment which is Nov. 1 through Dec. 15.
Teigen said there is a real problem with the fact that the programs through the state are “insanely rich in benefits and insanely expensive for the state.” Arkansas Works and Medicaid don’t have deductibles, and a maximum of $640 in out-of-pocket expenses in a year. By contrast, the average person on the federal marketplace has a $3,000 to $5,000 deductible.
“Arkansas can’t afford this type of coverage,” Teigen said. “I don’t know why bureaucrats didn’t come in and make this more affordable for the state. When a person goes from Arkansas Works to the federal marketplace, it is like day and night as far as your benefits are concerned.”