Health insurance in Arkansas
- Arkansas utilizes the federally run health insurance exchange so applicants enroll through HealthCare.gov.
- Open enrollment for 2019 coverage in Arkansas ended on December 15, but enrollment is still possible for Arizonans who have qualifying events.
- Short-term health plans are available in Arkansas with initial plan terms up to 364 days.
- Four insurers are offering 2019 coverage in the Arkansas individual market.
- The average premium for 2019 is just over 4 percent.
- About 68,000 Arkansas residents enrolled in 2018 coverage through the exchange.
- Arkansas accepted the ACA’s Medicaid expansion, but implemented a Private Option.
The Arkansas health marketplace
For the first three years of exchange implementation, Arkansas had a partnership exchange for individuals, but starting in 2016, the state has utilized a state-based exchange using the federal enrollment platform at HealthCare.gov. (Since the state already used HealthCare.gov for individuals, the change had little impact on the way Arkansans enroll.
The state has run its own exchange for small businesses since November 2015.
Open enrollment for 2019 coverage in Arkansas ended on December 15, but enrollment is still possible for Arizonans who have qualifying events.
Four insurers – Arkansas Blue Cross Blue Shield, Centene/Ambetter, QualChoice and QCA Health Plan – are offering 2019 individual-market plans in Arkansas. (The same four insurers offered 2018 individual-market plans in Arkansas.)
Enrollment in qualified health plans
Nearly 74,000 Arkansans signed up for exchange plans during the 2016 open enrollment period; about 27,250 of them were new to the exchange. 88 percent of those enrolled in plans through Arkansas’ exchange receive premium subsidies, the same amount as in 2015.
But enrollment dropped slightly in 2017, and again in 2018, when enrollment in private plans through the Arkansas exchange reached 68,100.
Read more about the Arkansas health insurance marketplace.
Medicaid expansion in Arkansas
Arkansas was the first state to receive federal approval for Medicaid expansion through the Private Option. The approach uses federal Medicaid money to subsidize the purchase of QHPs 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.
Although Medicaid expansion resulted in a significant increase in enrollment in the first few years, enrollment had stabilized by 2016. Total enrollment (including expanded coverage and traditional Medicaid) as of January 2017 stood at more than a million people, but had dropped to 931,000 by January 2018. The state attributed the decrease in enrollment to a stronger economy and the state’s review of enrollees’ eligibility.
As of October 2018, there were 252,642 people covered under expanded Medicaid in Arkansas. (They wouldn’t be eligible for Medicaid if the state hadn’t expanded the program under the ACA.) That number has been dropping in 2018, due to the state’s newly implemented Medicaid work requirement.
Read more about Medicaid expansion in Arkansas.
Short-term health insurance in Arkansas
Arkansas defaults to federal regulations for short-term health insurance, which means plans can have initial terms up to 364 days and total duration – including renewals – up to 36 months.
However, short-term rates must go through the state’s review process and Arkansas requires short-term plans to cover many state-mandated benefits.
Read more about short-term health insurance in Arkansas.
Arkansas health ratings
Arkansas was ranked 49th on the Scorecard on State Health System Performance 2015, which compared the 50 states and the District of Columbia. On the 2017 edition of the Scorecard, Arkansas moved up one spot, to 48th. The score is based on measures within five categories: Access, Prevention and Treatment, Avoidable Hospital Use and Costs, Healthy Lives, and Equity. Arkansas’ best ranking was for Prevention & Treatment, with 40th place. But for both Healthy Lives and Equity, the state came in 48th.
Arkansas ranked 51st in the nation—the absolute worst—in terms of the percentage of non-elderly adults whose out-of-pocket costs for medical care are considered unaffordable based on their income. But the state ranked 12th for the percentage of adults with a usual source of health care, a metric that’s associated with better health outcomes.
See the Arkansas scorecard for rankings on individual measures.
America’s Health Rankings, most recently published in 2017, also puts Arkansas at 48th, which was the same ranking they assigned the state in 2015. Although Arkansas is very near the bottom of the rankings, the report notes that Arkansas fared considerably better than Louisiana and Mississippi, which occupy spots 49 and 50. Compared with others in the ranking, Arkansas has a relatively low disparity in health status and relatively high public health funding, and it faces significant challenges when it comes to access to dentists and primary care physicians, childhood and adolescent immunization rates, and lack of insurance.
The 2016 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. The Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin compiled this detailed evaluation. This analysis found the physician to patient ratio was 1,540:1 overall in Arkansas, ranging from 870:1 to 10,350:1. The nation’s top-performers had a ratio of 1,040:1.
How has Obamacare helped Arkansas?
Arkansas is arguably among the nation’s ACA success stories.
According to U.S. Census data, Arkansas had an uninsured rate of 16 percent in 2013. That number fell to 7.9 by 2016, which was more than a 50 percent reduction. 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.
A big part of Arkansas’ success in reducing the uninsured rate is due to the state’s expansion of Medicaid. As of January 2018, there were about 285,000 people enrolled in Arkansas Works, and Medicaid enrollment in the state has increased by 63 percent since 2013.
But Arkansas obtained permission in March 2018 to implement a work requirement for Arkansas Works, effective in June 2018, which will likely result in a reduction in the number of people covered by the program.
Arkansas and the Affordable Care Act
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.
In September 2014, the board of the Arkansas Health Insurance Marketplace, voted to transition to a state-run exchange. The state-run exchange began offering coverage during the 2017 open enrollment period, although Gov. Asa Hutchinson had previously questioned whether the state should move ahead with its plans, after the Supreme Court’s 2015 decision in King v. Burwell that ensured that subsidies would continue to be available in states that use the federally-run exchange.
As of September 24, 2015, the state’s progress toward creating a state-run exchange was “on pause,” according to Gov. Hutchinson, but it soon got back on track, and the state-run exchange was up and running in time for the November 2016 start of the open enrollment period for 2017 coverage.
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 with an effective date of January 1, 2014, through Arkansas’ health insurance exchange.
Arkansas Medicare enrollment
As of July 2015, Arkansas Medicare enrollment had reached 594,596, nearly 20 percent of the state’s population. Seventeen percent of the U.S. population is enrolled in Medicare. Arkansas is among the states with the highest percentage of Medicare recipients who qualify due to a disability: 23 percent. The other 77 percent of Arkansas Medicare beneficiaries qualify based on age alone.
Arkansas Medicare beneficiaries who want to gain some additional benefits may select a Medicare Advantage plan instead of original Medicare. 21 percent of the state’s Medicare enrollees have Medicare Advantage plans instead of traditional plans. Nationwide, 33 percent of enrollees have Medicare Advantage.
Medicare Part D plans are also an option for those who want to add stand-alone prescription drug coverage to their traditional Medicare coverage. Half of all Arkansas Medicare recipients (51 percent) are enrolled in Part D plans compared with 45 percent of all Medicare recipients.
Arkansas health insurance resources
- Arkansas Center for Health Improvement
- Arkansas Insurance Department Consumer Services Division
- ARKIDS 1ST
Health reform legislation in Arkansas
Scroll to the bottom of the page for a summary of recent healthcare-related legislation in Arkansas.
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. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.