65,684 Arkansas residents signed up for health insurance on HealthCare.gov between Nov. 15 and Feb. 22 according to the U.S. Department of Health and Human Services (HHS). 44 percent were new to the exchange for 2015, and 88 percent qualified for premium subsidies.
2015 open enrollment is over now, but a tax penalty-related special enrollment period (SEP) runs from March 15 through April 30. It’s open to consumers who discovered they must pay a tax penalty when filing their 2014 returns. Those consumers can get covered and minimize penalties on their 2015 taxes, but they will still be responsible for their 2014 tab.
There are some other conditions under which people can apply for health insurance coverage before the next open enrollment period, but they must have a qualifying event in order to purchase coverage outside of open enrollment, on or off the exchange.
Arkansas carves own path on ACA
Arkansas has not followed the pack in its approach to implementing the Affordable Care Act, and it is continued that trend in the fall of 2014. 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 in the fall of 2015.
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 moved to a state-run exchange, while Oregon and Nevada increased 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. The state also pioneered the Private Option for Medicaid expansion. However, with Republicans now holding large majorities in both houses of the state legislature, Arkansas may lead in the opposite direction by becoming the first state to drop out of Medicaid expansion.
Premiums lower in 2015
The Arkansas Insurance Department announced 2015 premiums are two percent lower on average compared to 2014 rates. You can browse plans and premiums available in your area by visiting HealthCare.gov and entering your ZIP code.
Arkansas Health Connector enrollment in 2014
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. An HHS report released in June 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.
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.
In December 2014, Arkansas received federal approval for two further changes to its version of Medicaid expansion. The waiver allows a requirement of monthly contributions to health savings accounts and limits transportation for routine doctor visits and other non-emergency services.
As originally constructed, the Private Option required annual reauthorization by the Arkansas legislature. In late February 2014, the Arkansas Senate approved continued funding for the Private Option. However, 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.
Legislative support for the Private Option was weakened by the 2014 elections. Republicans, many of whom campaigned against the Private Option, now hold 24-11 and 64-36 majorities in the state Senate and House, respectively.
Gov. Asa Hutchinson asked state legislators to fund the program in its current form through the end of 2016. Legislators heeded Hutchinson’s request by passing Act 46. The law continues Private Option funding through 2016 and establishes a task force to suggest changes to the program for 2017. However, some opponents believe they have killed the Private Option, viewing Act 46 as just a “stay of execution.”
Arkansas legislators are also considering SB 312, which would direct the state Department of Human Services to request federal approval to freeze enrollment in the Private Option effective Dec. 31, 2015. Through January 2015, about 233,500 Arkansas residents were enrolled in the Private Option.
Arkansas health insurance exchange links
Arkansas Health Connector
Arkansas Health Insurance Marketplace Board
Website for nonprofit overseeing Arkansas’ transition to a state-run marketplace