Frequently asked questions about health insurance
coverage options in Arkansas
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.
Read our overview of the history of the Arkansas health insurance marketplace.
The open enrollment period for 2022 coverage ran from November 1, 2021 to January 15, 2022. Outside of open enrollment, a special enrollment period is necessary in order to enroll in a new plan or switch to a different plan.
Most special enrollment periods are triggered by a qualifying life event, although some special enrollment periods (such as the enrollment opportunity for Native Americans, or for people earning under 150% of the poverty level) don’t depend on a specific life event.
Plans are available statewide from four insurers in the Arkansas exchange, including Oscar, which joined for 2022. All of the insurers offer plans statewide, giving residents in the state more insurer options than people in many other states (some of the state’s insurers offer plans via multiple affiliates).
Plans are available in the Arkansas exchange for 2022 from the following insurers:
- Ambetter (QualChoice: QC Life and Health, QCA Health Plan)
- Arkansas Blue Cross Blue Shield (USAble Mutual)
- Health Advantage (HMO Partners; an affiliate of Arkansas Blue Cross Blue Shield)
Overall average premiums in the Arkansas individual market increased by 4.4% for 2022, before any subsidies were applied. And the average doesn’t count Oscar’s premiums, since they were new for 2022 and thus had no applicable rate change. The following average rate changes were approved by the Arkansas Insurance Department for 2022:
- Arkansas Blue Cross Blue Shield (USAble Mutual): 6.25% increase
- Ambetter (Celtic/Centene): 0.5% increase
- QualChoice Life and Health (Ambetter): 3.9% increase
- QCA Health Plan (Ambetter): 3.9% increase
- Health Advantage (HMO Partners/ARBCBS): 7.77% increase
- Oscar: New for 2022, so no applicable rate change.
By December 15, 2021, with a month remaining in the open enrollment period for 2022 coverage, 81,947 people had signed up for non-Medicaid private plans through the Arkansas exchange. That was already significantly higher than the total number of people (66,094) who had enrolled during the open enrollment period a year earlier.
Although a total of 328,497 people were enrolled in private plans through the exchange as of 2021, most of these people were enrolled in the state’s Medicaid program. Arkansas uses Medicaid funding to purchase private plans in the marketplace for people who are eligible for Medicaid under the state’s ACA Medicaid expansion.
Medicaid is a health insurance option available for people with little or very low income or those who have a disability. Medicaid is a joint state and federal program. The federal government defines broad requirements, and the state determines eligibility levels and operates the program. Some people qualify for both Medicaid and Medicare.
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% 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.
Arkansas Works used to be the name of the Medicaid expansion program in Arkansas, but it has changed to Arkansas Health and Opportunity for ME (ARHOME) as of 2022.
As of October 2018, there were 252,642 people who had coverage under Arkansas Works. 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 was never reinstated (the Biden administration officially revoked approval for it in 2021).
By 2021, enrollment in Arkansas Works was well above 300,000, with the increase driven largely by the COVID pandemic.
Total Medicaid enrollment in Arkansas (including the Arkansas Works population as well as ARKids First) stood at 928,487 as of July 2021. This was 65% higher than it had been in 2013, before Medicaid expansion took effect.
Read more about Medicaid expansion in Arkansas.
Arkansas defaults to federal regulations for short-term health insurance, which means short-term health insurance coverage in Arkansas 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 medical insurance in Arkansas to cover many state-mandated benefits.
Read more about short-term health insurance in Arkansas.
Arkansas is arguably among the nation’s ACA success stories.
According to U.S. Census data, Arkansas had an uninsured rate of 16% in 2013. That number fell to 7.9% by 2016, which was more than a 50% reduction – although it increased to 8.2% by 2018 and to 9.1% by 2019
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 in the uninsured rate from where it was in 2013.
A big part of Arkansas’ success in reducing the uninsured rate is due to the state’s expansion of Medicaid. As of 2021, there were more than 300,000 people enrolled in Arkansas Works (the state’s expansion program, which has since been renamed Arkansas Health and Opportunity for ME, or ARHOME), and as of June 2021, total Medicaid/CHIP enrollment in the state was up about 65% from where it had been prior to expansion.
This was higher than Medicaid expansion enrollment had been in 2018, before the state’s short-lived Medicaid work requirement was implemented. The work requirement was overturned by a judge in early 2019, but it resulted in thousands of people losing their coverage during the months it was in effect in the latter part of 2018.
Arkansas has mostly embraced the ACA, expanding Medicaid via an 1115 waiver that allows the state to purchase private plans for Medicaid expansion enrollees (albeit with a controversial work requirement that took effect in 2018 but was later overturned by a judge), operating a fully state-based small business exchange from 2016 through 2018 (no carriers opted to participate as of 2019, so the state is no longer running a small business exchange), and as of 2017, running a state-based exchange for individuals using the HealthCare.gov enrollment platform.
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.
There were 651,967 Arkansas residents enrolled in Medicare as of late 2021. About 35% of Arkansas Medicare enrollment is in Medicare Advantage plans.
Read more about Medicare in Arkansas, including the state’s Medigap rules and the availability of private Medicare plans, as well as specifics pertaining to Medicare enrollment.
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; note that this is not the same as the Children’s Health Insurance Program) was created in 1996 to provide medical insurance in Arkansas 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 individual major medical insurance 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.