The second open enrollment period on HealthCare.gov runs through Feb. 15, and signups are off to a good start. According to the U.S. Department of Health and Human Services (HHS), 54,885 Arkansas residents signed up for health insurance on HealthCare.gov between Nov. 15 and Jan. 16. An earlier report indicated that 89 percent of those enrolling had qualified for financial assistance to pay for their premiums.
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 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. 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.
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 is the best option again in 2015 — their needs might have changed, or the insurer might have adjusted the policy or its cost.
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. Through December 2014, nearly 213,000 Arkansas residents have enrolled in the Private Option.
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.
The Private Option requires annual reauthorization by the Arkansas legislature. In late February 2014, 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 immediately pledged to fight against the Private Option again in 2015.
Legislative support for the Private Option was weakened by the 2014 elections. Numerous Republicans who vowed to discontinue the Private Option during their 2014 campaigns will vote on the issue at some point in the 2015 session. Republicans now hold 24-11 and 64-36 majorities in the state Senate and House, respectively.
The Private Option may also be jeopardized by a Government Accountability Office (GAO) report that said Arkansas’ private option is not budget-neutral to the federal government, as is required by HHS.
However, the Private Option got a boost from newly seated Gov. Asa Hutchinson. Hutchinson did not take a firm stance on the Private Option during his campaign or during his first weeks in office. However, in a Jan. 22 speech, he asked state legislators to fund the program in its current form through the end of 2016. Hutchinson said he’d appoint a task force to suggest changes to the program for 2017, but continuing the current program for two years “avoids harm to the 200,000-plus in the private option, and it assures our hospitals and providers of financial stability.”
Arkansas health insurance exchange links
Arkansas Health Connector
Arkansas Health Insurance Marketplace Board
Website for nonprofit overseeing Arkansas’ transition to a state-run marketplace