Arkansas health insurance
Health, health care reform and how the ACA is lowering the uninsured rate in the 'Natural State'
By Carla Anderson
August 5, 2014
Arkansas is known as The Natural State for its beautiful waterways and abundant wildlife. However, the state’s scores on public health indicators aren’t so pretty. See how Arkansas compares to other states in terms of health status and consider if expanded health insurance coverage through the Affordable Care Act can play a role in boosting the state’s overall health.
Arkansas health ratings
Arkansas is ranked 50th on the Scorecard on State Health System Performance 2014‘s comparison of the 50 states and the District of Columbia. The score is based on measures within four categories: access, prevention and treatment, avoidable hospital use and costs, and healthy lives. See the Arkansas Scorecard for rankings in the individual measures. Arkansas was ranked 49th in the 2013 evaluation.
America’s Health Rankings, most recently published in 2013, puts Arkansas at 49th. The low ranking arises from a high uninsured rate; high rates of obesity, smoking, and physical inactivity; limited availability of dentists; and low childhood immunization rates. Arkansas scored well for the low rate of binge drinking and limited health disparities across educational attainment levels.
The 2014 edition of Trust for America’s Health is another resource for reviewing a variety of public health indictors. See Key Health Data About Arkansas.
If the state-level evaluations don’t meet your needs, get county-by-county health rankings for Arkansas. This detailed evaluation was compiled by the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin.
Arkansas and the Affordable Care Act
Arkansas Sen. Blanche Lincoln and Mark Pryor were two of only three Democratic senators who voted against the Affordable Care Act. Lincoln lost her re-election bid in 2010. Rep. Robert Berry, Rep. Vic Snyder, and Rep. Mike Ross – all Democrats – voted in favor of the ACA in the House. All three have since left office. Republican Rep. John Boozman voted against the bill and now represents Arkansas in the U.S. Senate.
At the state level, a bill to establish a state-run exchange was considered during the 2011 legislative session but did not pass. The Arkansas Department of Insurance then shifted gears and received grant money in February 2012 to develop a partnership exchange.
Going forward, the state is exploring a state-run exchange. It has hired an executive director, Cheryl Smith, to lead the Arkansas Health Insurance Marketplace, which would manage the transition to a state-run exchange. Smith told the Arkansas News that a July 2014 ruling by a federal circuit court could accelerate the state’s efforts. The decision, if it stands, could end tax subsidies through the federal exchange. Implementing “a state-based exchange will be the only way subsidies can flow,” said Smith.
How did the ACA help Arkansas?
The implementation of the Affordable Care Act had a significant impact on Arkansas’ estimated uninsured rate. The rate dropped 7.1 percent – falling from 20.87 percent pre-open enrollment to 13.77 percent post-open enrollment. Enrollment in qualified health plans (QHPs), qualifications for Medicaid or the Children’s Health Insurance Program (CHIP) under existing eligibility requirements, and Medicaid/CHIP qualifications under expanded eligibility rules all contributed to the drop.
Enrollment in QHPs
In Arkansas, 43,446 eligible individuals, or 19.1 percent of the estimated eligible market in the state Arkansas enrolled in a QHP during 2014 open enrollment.
Four insurers offered 71 policy options through the Arkansas marketplace during 2014 open enrollment: Arkansas Blue Cross and Blue Shield, QualChoice of Arkansas, NovaSys Health, and National Blue Cross Blue Shield Multi-state Plan.
Arkansas first to propose ‘private option’ for Medicaid
Arkansas was the first state to receive federal approval to expand Medicaid through the “private option.” The approach uses federal Medicaid money to subsidize the purchase of QHP plans through the marketplace for individuals earning up to 138 percent of the federal poverty level. A number of other states have shown interest in and adopted the approach. As of mid-June 2014 about 172,000 Arkansans had completed enrollment for the private option.
Does Arkansas have a high-risk pool?
Before the ACA reformed the individual health insurance market, coverage was underwritten in almost all states, including Arkansas. This meant that applicants’ medical histories were scrutinized before they could purchase coverage. People with pre-existing conditions were often unable to purchase a plan in the private market, or could only get one that excluded pre-existing conditions.
The Arkansas Comprehensive Health Insurance Pool (CHIP) was created in 1996 to provide an alternative for people who were unable to purchase individual health insurance because of their medical history.
A major component of the ACA is the requirement that all policies be guaranteed issue starting in 2014. Since there is no longer medical underwriting in the major medical individual market, the need for high risk pools has largely been eliminated. CHIP ceased operations on December 31, 2014, as applicants were able to secure guaranteed issue coverage through the exchange with an effective date of January 1, 2014.
Health reform legislation in Arkansas
Here’s a summary of state legislative action regarding healthcare reform in Arkansas: