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.
This window does not require a qualifying event (normally necessary in order to enroll or make a plan change outside of open enrollment), and is open to people who are uninsured as well as people who already have coverage and would like to make a change.
This makes it a great opportunity for people to enroll or switch plans in order to best take advantage of the American Rescue Plan’s enhancement of premium subsidies. Plans selected during this COVID-related enrollment window will take effect the first of the following month.
Plans are available statewide from three insurers in the Arkansas exchange, giving residents in the state more insurer options than people in many other states.
Individual market insurers raised average rates by 3.4% for 2021.
- Arkansas Blue Cross Blue Shield (USAble Mutual): 2.9% increase
- Ambetter (Celtic/Centene): 4.9% increase
- QualChoice Life and Health (now owned by Centene/Ambetter; plans are marketed as Ambetter): 3% increase
- QCA Health Plan (now owned by Centene/Ambetter; plans are marketed as Ambetter): 3% increase
During the open enrollment period for 2021 health coverage, 66,094 people enrolled in plans through the Arkansas exchange.
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 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.
Arkansas Works is the name of the Medicaid expansion program in Arkansas.
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 has not been reinstated. By June 2020, total enrollment in Arkansas Works had grown to 277,284, which was an increase of about 14,000 people in two months, driven largely by the spike in unemployment due to the COVID-19 pandemic.
Total Medicaid enrollment in Arkansas (including the Arkansas Works population as well as ARKids First) stood at 853,216 as of September 2020. This was 53 percent 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 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 and to 9.1 percent 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 June 2020, there were more than 277,000 people enrolled in Arkansas Works (the state’s expansion program), and as of September 2020, total Medicaid enrollment in the state was up about 53 percent from where it had been prior to expansion.
But it’s noteworthy that enrollment had been even higher in 2018. As of January 2018, there were about 285,000 people enrolled in Arkansas Works, and Medicaid enrollment in the state was up about 54 percent over what it had been in 2013. 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 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 in 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.
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.