Arkansas has not followed the pack in its approach to the health insurance marketplace, and it is continuing that trend this fall. The board of the Arkansas Health Insurance Marketplace voted in mid-September to transition from its current partnership exchange to a state-run exchange.
For individuals, the Arkansas-run marketplace will be operational for open enrollment in the fall of 2016, with coverage beginning in 2017. For small businesses, operations will begin a year earlier.
States that relied on the federal marketplace for some or all functions outnumbered states that ran their own exchanges in 2014. For 2015, only Idaho is moving to a state-run exchange, while Oregon and Nevada are increasing their reliance on the federal marketplace.
Arkansas’ transition toward a state-run marketplace is not its only atypical move. Arkansas was one of just a few states that implemented a state-federal partnership for 2014, and it also pioneered the “private option” for Medicaid expansion.
Arkansas health connector enrollment
Signups for qualified health plans (QHPs) in Arkansas totaled 43,446 during 2014 open enrollment. Among Arkansas residents selecting a QHP, 90 percent qualified for financial assistance, compared to 85 percent nationally. A report released in June by the U.S. Department of Health and Human Services showed the average monthly premium, after tax credits, for Arkansas consumers was $94. Thirty-five percent of enrollees who received subsidies in 2014 saw their premiums reduced to $50 or less per month.
Nineteen percent of Arkansas residents selected a bronze plan (20 percent nationally), 67 percent selected a silver plan (65 percent nationally), 13 percent selected a gold plan (9 percent nationally), 0 percent selected a platinum plan (5 percent nationally) and 1 percent selected a catastrophic plan (2 percent nationally). Twenty-five percent of Arkansas enrollees were between the ages of 18 and 34.
How 2015 premiums are shaping up
The Arkansas Insurance Department is projecting 2015 premiums to decrease two percent on average, as compared to 2014 rates. 2015 rates are still under review by the federal government and will be finalized sometime before open enrollment begins Nov. 15.
Despite the overall good news on premiums, consumer advocates are urging individuals to actively look into their options for 2015. Consumers shouldn’t assume the specific policy they purchased for 2014 will be the best choice again in 2015 — their needs might have changed, or the insurer might have adjusted the policy or its cost.
Arkansas’ historical approach to the marketplace
The Arkansas legislature considered a bill to establish a state-run exchange during the 2011 session, but it did not pass. The Arkansas Insurance Department then shifted gears and received grant money in February 2012 to develop a partnership exchange.
The state exchange website is called Arkansas Health Connector, and it provides key dates for enrolling, frequently asked questions and other information to help people understand their options for purchasing health insurance. State residents use the federal marketplace, HealthCare.gov, to compare plans, see if they qualify for subsidies, and purchase coverage.
Arkansas was the first state to receive federal approval to expand Medicaid through the private option. Through the private option, the state uses money earmarked through the ACA for Medicaid expansion to subsidize the purchase of private insurance. The approach has been adopted or considered by a number of other states. Through August 2014, more than 194,000 Arkansas residents have completed enrollment for the private option according to the Arkansas News.
While the Arkansas legislature authorized the private option in 2013, it requires reauthorization annually. In late February, the Arkansas Senate approved continued funding for the private option. It took the House five votes to reauthorize funding in early March. Arkansas appropriation bills must receive a 75 percent majority in both houses to pass, and the private option just squeaked by with votes of 27-8 in the Senate and 76-24 in House. Some Republican legislators are already saying they will fight against the private option again next year, and the issue was cited in several state primary campaigns.
The private option may also be jeopardized by a recent Government Accountability Office (GAO) report that said Arkansas’ private option is not budget-neutral to the federal government, as is required by the U.S. Department of Health and Human Services.
Arkansas health insurance exchange links
Arkansas Health Connector
Arkansas Health Insurance Marketplace Board
Website for nonprofit overseeing Arkansas’ transition to a state-run marketplace
State Exchange Profile: Arkansas
The Henry J. Kaiser Family Foundation overview of Arkansas’s progress toward creating a state health insurance exchange.