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Arkansas Health Insurance Consumer Guide
We designed this guide, including the FAQs below, to help you understand your health insurance coverage options in Arkansas. For many people, an Affordable Care Act (ACA) Marketplace plan – also called Obamacare – is a cost-effective choice.
Arkansas residents enroll in ACA-compliant plans through a state-based exchange/Marketplace that utilizes the federal enrollment platform (SBE-FP). This means people enroll through HealthCare.gov, but the state (via the Arkansas Insurance Department) oversees the exchange plans and runs its own outreach and assistance programs.1 Arkansas has used this approach since 2016.
Arkansas also purchases Marketplace health plans for people who are eligible for expanded Medicaid.
Explore our other comprehensive guides to coverage in Arkansas
Dental coverage in Arkansas
In 2023, there are three insurers that offer stand-alone individual/family dental coverage through the health insurance marketplace in Arkansas.2 Learn about the various dental coverage options in our state guide.
Arkansas’ Medicaid program
Arkansas adopted the ACA’s Medicaid expansion in 2014. As of 2023, more than 340,000 people were enrolled in the expansion program – known as Arkansas Health and Opportunities for Me (ARHOME).3
Medicare coverage and enrollment in Arkansas
There are nearly 670,000 Medicare beneficiaries in Arkansas as of 2023.4 Read our overview of Medicare enrollment and coverage options in Arkansas.
Short-term coverage in Arkansas
Arkansas residents can buy short-term health insurance plans with initial durations up to 364 days. And as of 2023, at least nine insurers sell short-term plans in the state.5
Frequently asked questions about health insurance in Arkansas
Who can buy Marketplace health insurance?
To be eligible for health coverage through the Arkansas Marketplace, you must meet certain criteria. Typically, you can apply if you:6
- Reside in Arkansas
- Are either a U.S. citizen, U.S. national, or lawfully present in the U.S.
- Are not incarcerated
- Are not enrolled in Medicare
So most Arkansas residents are eligible to enroll in a Marketplace plan. However, a more important question for most people is whether they’re eligible for financial assistance (premium subsidies and cost-sharing reductions) in the Marketplace.
Eligibility for financial assistance depends on your income. In addition, to qualify for financial assistance with your Marketplace plan you must:
- Not have access to affordable employer-sponsored health insurance. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.
- Not be eligible for Medicaid or CHIP.
- Not be eligible for premium-free Medicare Part A.7
- File a joint tax return with your spouse, if you’re married.8 (with very limited exceptions)9
- Not be able to be claimed by someone else as a tax dependent.8
When can I enroll in an ACA-compliant plan in Arkansas?
The open enrollment period to buy individual and family health coverage in Arkansas runs from November 1 to January 15. Here are some key dates:10
- November 1: Open enrollment starts! This is when you can first sign up for or change plans for the 2024. If you enroll by December 15, your coverage will start on January 1.
- December 15: Last day to enroll or change plans to start on January 1. After this date, any changes or new plans won’t start until February 1.
- January 15: Open enrollment ends. After this, you only change or enroll in coverage through a special enrollment period (SEP).
An SEP allows you to make plan changes outside open enrollment if you’ve had a qualifying life event, like getting married, having a baby, or losing other health coverage.11
But some people can sign up without a qualifying life event. For example:
- Native Americans can enroll in Marketplace plans year-round.12
- People eligible for subsidies with income under 150% of the poverty level can enroll anytime until at least the end of 2025.13
- People who lose Medicaid/CHIP between March 31, 2023 and July 31, 2024 are eligible for a temporary extended SEP.14
How do I enroll in a Marketplace plan in Arkansas?
If you’re eligible for an ACA Marketplace plan, you can enroll:
- Online through HealthCare.gov
- By phone at (800) 318-2596
- With the help of a local insurance agent/broker, Navigator, or certified application counselor
- Via an approved enhanced direct enrollment entity.15
How can I find affordable health insurance in Arkansas?
You can find affordable health plans in Arkansas on the ACA Marketplace (HealthCare.gov).
During the 2023 open enrollment period, over 90% of enrollees qualified for premium subsidies ( Advance Premium Tax Credits, or APTC). With an average subsidy of $481 per month, the average after-subsidy premium was $104 per month.16
Source: CMS.gov16
If your income isn’t more than 250% of the federal poverty level, you may also qualify for cost-sharing reductions (CSR) to lower your deductibles and out-of-pocket costs.17
You may enroll in Medicaid coverage if eligible. Arkansas expanded Medicaid under the ACA, and the state purchases Marketplace health plans for people who are eligible for expanded Medicaid.
Short-term plans can be a lower-cost coverage option for people not eligible for Medicaid, Medicare, or subsidized Marketplace coverage. But it’s important to understand the drawbacks of short-term coverage before purchasing it, as these plans are not regulated by the ACA.
How many insurers offer Marketplace coverage in Arkansas?
The Arkansas exchange offers individual and family health plans from five insurers for 2024,18 although some are subsidiaries or licensees of a single parent entity.
Are Marketplace health insurance premiums increasing in Arkansas?
The Arkansas Insurance Department announced the following approved average rate changes for 2024 individual/family Marketplace health plans,19 which amount to an overall average rate increase of 4.1%.20
Arkansas’ ACA Marketplace Plan 2024 Approved Rate Increases by Insurance Company |
|
---|---|
Issuer | Percent Increase |
Celtic Insurance Company (Ambetter) | 2.2% |
HMO Partners, Inc (Health Advantage) | 2.13% |
QCA Health Plan, Inc. | -1.7% |
QualChoice Life and Health Insurance Company, Inc. | 0.1% |
USAble Mutual Insurance Co. (AR Blue Cross & Blue Shield/Octave) | 7.72% |
The rate changes are for full-price premiums. But most people in Arkansas receive subsidies to lower their costs, so their rate change may be different.16
For perspective, here’s an overview of how unsubsidized average premiums have changed in Arkansas over the years:
- 2015: Average decrease of 2%.21
- 2016: Average increase of 4.4%.22
- 2017: Average increase of 9.1%.23
- 2018: Average increase of 17.5%.24
- 2019: Average increase of 4.1%.25
- 2020: Average increase of 2.3%.26
- 2021: Average increase of 3.4%.27
- 2022: Average increase of 4.4%.28
- 2023: Average increase of 5.9%.29
How many people are insured through Arkansas’ Marketplace?
During the open enrollment period for 2024 coverage, a record-breaking 156,607 people enrolled in private plans through the Arkansas Marketplace.30 (See chart below with historical enrollment data.)
That came on the heels of a previous record high the year before, when just over 100,000 Arkansans signed up for private health plans through the ACA Marketplace.16
The enrollment growth in recent years was driven in large part by the American Rescue Plan’s subsidy enhancements, which have been extended through 2025 by the Inflation Reduction Act. These subsidy enhancements make coverage more affordable than it was before 2021.
The enrollment spike in 2024 was also partially due to the “unwinding” of the pandemic-era Medicaid continuous coverage rule. Medicaid disenrollments resumed in the spring of 2023, and Arkansas had completed the unwinding process by October 2023, with more than 427,000 people disenrolled from Medicaid.31
HealthCare.gov is offering an extended special enrollment period, through July 2024, for people disenrolled from Medicaid during the unwinding period. But by October 2023, more than 26,000 people had transitioned from Arkansas Medicaid to a private plan offered in the Arkansas Marketplace,32 helping to drive 2024 enrollment higher than it had been in recent years.
Source: 2014,33 2015,34 2016,35 2017,36 2018,37 2019,38 2020,39 2021,40 2022,41 202342
What health insurance resources are available to Arkansas residents?
HealthCare.gov
This is the ACA Marketplace where you can enroll in a health insurance plan online. You may also get help by calling (800) 318-2596.
Arkansas Center for Health Improvement
Nonprofit focused on improving healthcare access and public health in Arkansas.
Arkansas Insurance Department Consumer Services Division
Regulates insurance companies and assists consumers. Can help with health insurance questions, complaints, and more.
ARKids First
Arkansas’ Children’s Health Insurance Program. Provides low-cost health coverage for children in families who earn too much for Medicaid but can’t afford other insurance.
Arkansas Senior Health Insurance Information Program
Provides local Medicare counseling and assistance. Can help answer questions, resolve issues, and enroll in Medicare plans.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
Footnotes
- My Arkansas Insurance. Arkansas Insurance Department. Accessed November 2023. ⤶
- “Arkansas dental insurance guide 2023” healthinsurance.org, Accessed September 2023 ⤶
- “Medicaid eligibility and enrollment in Arkansas” healthinsurance.org, March 28, 2023 ⤶
- “Medicare Monthly Enrollment” CMS.gov, April 2023 ⤶
- “Availability of short-term health insurance in Arkansas” healthinsurance.org, Sept. 7, 2023 ⤶
- ”A quick guide to the Health Insurance Marketplace” HealthCare.gov ⤶
- Medicare and the Marketplace, Master FAQ. Centers for Medicare and Medicaid Services. Accessed November 2023. ⤶
- Premium Tax Credit — The Basics. Internal Revenue Service. Accessed MONTH. ⤶ ⤶
- Updates to frequently asked questions about the Premium Tax Credit. Internal Revenue Service. February 2024. ⤶
- “When can you get health insurance?” HealthCare.gov, 2023 ⤶
- “Understanding special enrollment periods” CMS.gov, March 2023 ⤶
- “Who doesn’t need a special enrollment period?“ healthinsurance.org, Accessed August 2023 ⤶
- “An SEP if your income doesn’t exceed 150% of the federal poverty level” healthinsurance.org, Feb. 1, 2023 ⤶
- “Temporary Special Enrollment Period (SEP) for Consumers Losing Medicaid or the Children’s Health Insurance Program (CHIP) Coverage Due to Unwinding of the Medicaid Continuous Enrollment Condition– Frequently Asked Questions (FAQ)” CMS.gov, Jan. 27, 2023 ⤶
- “Entities Approved to Use Enhanced Direct Enrollment” CMS.gov, April 28, 2023 ⤶
- “2023 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2023 ⤶ ⤶ ⤶ ⤶
- ”APTC and CSR Basics” Centers for Medicare and Medicaid Services. June 2023. ⤶
- “Health Insurance Rate Changes for 2023” Arkansas Insurance Department, Accessed November 2023 ⤶
- “Health Insurance Rate Changes for 2024” Arkansas Insurance Department, Accessed September 2023 ⤶
- Arkansas: *Final* Avg. Unsubsidized 2024 #ACA Rate Changes: +4.1%. ACA Signups. September 2023. ⤶
- 2015 Projected Qualified Health Plan Individual Premium Rates for Arkansas. Arkansas Insurance Department. Accessed November 2023. ⤶
- Arkansas: Approved 2016 Rate Hikes Confirmed At 4.4% Weighted Avg. ACA Signups. August 2015. ⤶
- Avg. UNSUBSIDIZED Indy Mkt Rate Hikes: 25% (49 States + DC). ACA Signups. October 2016. ⤶
- 2018 Rate Hikes. ACA Signups. October 2017. ⤶
- Arkansas: APPROVED 2019 ACA Rate Hikes: 4.1%, But Would Have DROPPED By ~1% W/Out #ACASabotage. ACA Signups. August 2018. ⤶
- Arkansas: *Approved* Avg. 2020 #ACA Exchange Rate Changes: 2.3% Increase. ACA Signups. September 2019. ⤶
- Arkansas: Approved Avg. 2021 #ACA Rate Changes: +3.4% Indy Market, -0.4% Sm. Group Market. ACA Signups. October 2020. ⤶
- Arkansas: Approved Avg. 2022 #ACA Premium Rate Changes: +4.4% Indy Market; +4.0% Sm. Group. ACA Signups. October 2021. ⤶
- Arkansas: (Updated) Final Avg. Unsubsidized 2023 #ACA Rate Changes: +5.9%. ACA Signups. July 2022. ⤶
- ”Marketplace 2024 Open Enrollment Period Report: Final National Snapshot” Centers for Medicare and Medicaid Services. January 2024. ⤶
- Unwinding data for April, May, June, July, August, and September. Arkansas Department of Human Services. Accessed December 2, 2023. ⤶
- HealthCare.gov Marketplace Medicaid Unwinding Report. Centers for Medicare and Medicaid Services. Data through October 2023. ⤶
- “ASPE Issue Brief (2014)” ASPE, 2015 ⤶
- “Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report”, HHS.gov, 2015 ⤶
- “HEALTH INSURANCE MARKETPLACES 2016 OPEN ENROLLMENT PERIOD: FINAL ENROLLMENT REPORT” HHS.gov, 2016 ⤶
- “2017 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2017 ⤶
- “2018 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2018 ⤶
- “2019 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2019 ⤶
- “2020 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2020 ⤶
- “2021 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2021 ⤶
- “2022 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2022 ⤶
- “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, 2023 ⤶