Health insurance in Arkansas
- Arkansas utilizes the federally run health insurance exchange so applicants enroll through HealthCare.gov.
- Open enrollment for 2020 coverage in Arkansas has ended, although residents with qualifying events may still be able to enroll or make changes to their coverage for 2020. The next open enrollment period begins in November 2020, for plans effective in 2021.
- Short-term health plans can be sold in Arkansas with initial plan terms up to 364 days.
- Arkansas accepted the ACA’s Medicaid expansion, but implemented a Private Option.
- 21 percent of Arkansas residents are enrolled in Medicare.
The Arkansas health marketplace
For the first three years of exchange implementation, Arkansas had a partnership exchange for individuals, but since 2016, the state has utilized a state-based exchange using the federal enrollment platform at HealthCare.gov.
Open enrollment for 2020 coverage in Arkansas is over, but residents with qualifying events may still be able to enroll or make changes to their coverage for 2020, depending on the circumstances. The next open enrollment window, for plans effective in 2021, will begin November 1, 2020.
Read our full overview of the Arkansas health insurance marketplace.
Enrollment in qualified health plans
Nearly 74,000 Arkansans signed up for exchange plans during the 2016 open enrollment period. As was the case in most states that use HealthCare.gov, enrollment in the Arkansas exchange peaked in 2016.
Enrollment dropped slightly in 2017, and again in 2018, when enrollment in private plans through the Arkansas exchange reached 68,100.
Enrollment declined again in 2019, although only by about 1 percent, with 67,413 people signing up for 2020 plans in the state’s 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. Iowa and New Hampshire each tried this approach for a while, but both have since switched to regular Medicaid managed care instead.
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. That number dropped in 2018, due to the state’s newly implemented Medicaid work requirement. But the work requirement was overturned by a federal judge in early 2019, and is not currently being enforced.
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, and in the 2019 ranking, they moved up another spot, to 47th.
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.
The 2019 edition of America’s Health Rankings also puts Arkansas at 48th, above only Louisiana and Mississippi.
The 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.
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—although it increased to 8.2 percent by 2018 (nationwide, the uninsured rate has inched upward under the Trump administration). 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 52 percent since 2013.
But Arkansas obtained permission in March 2018 to implement a work requirement for Arkansas Works, effective in June 2018, which resulted in thousands of people losing their coverage before a judge overturned the work requirement in early 2019.
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 (which uses HealthCare.gov’s enrollment platform) 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 October 2019, Arkansas Medicare enrollment had reached 638,175 – more than 21 percent of the state’s population. A little less than 19 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, at 22 percent. The other 78 percent of Arkansas Medicare beneficiaries qualify based on age alone.
Medicare spends about $9,304 per Arkansas recipient annually. Nationally, average per-beneficiary Original Medicare spending stood at $9,533.
Arkansas Medicare beneficiaries have the option to select a Medicare Advantage plan instead of original Medicare. Twenty-one percent of the state’s Medicare enrollees had Medicare Advantage plans instead of traditional plans as of 2017 – compared to 33 percent of enrollees nationally who had 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 were enrolled in Part D plans in 2018.
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.