Health insurance in Arkansas
- Arkansas utilizes the federally run health insurance exchange so applicants enroll through HealthCare.gov.
- Open enrollment for 2021 coverage in Arkansas will begin November 1, 2020; residents with qualifying events can enroll outside of open enrollment.
- 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 ended in December 2019, but residents with qualifying events (including the loss of an employer-sponsored plan) can 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.
During the open enrollment period for 2020 health coverage, 64,360 people enrolled in plans through the Arkansas exchange.
Read our full overview of 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. 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 has not been reinstated.
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.
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 indicators. See Key Health Data About Arkansas.
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 54 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 medically underwritten in almost all states, including Arkansas. 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. 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
There were 641,980 Arkansas residents enrolled in Medicare as of early 2020.
Read more about Medicare in Arkansas, including the state’s Medigap rules.
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.