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 (SBE-FP). This means residents enroll in coverage via HealthCare.gov, but the state maintains oversight of the exchange, and runs its own outreach and enrollment assistance programs.
Read our overview of the history of the Arkansas health insurance marketplace.
The open enrollment period for individual/family coverage runs from November 1 through January 15 in Arkansas. Learn more in our comprehensive guide to open enrollment.
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.
In Arkansas, consumers may be able to buy affordable individual and family health insurance by enrolling through the ACA marketplace (HealthCare.gov). Nearly 90% of consumers who enrolled in 2022 coverage through their state exchange received premium subsidies.
Arkansans may also find affordable coverage through Medicaid if they’re eligible. See Medicaid eligibility guidelines in Arkansas.
Short-term health insurance is also a lower-cost coverage option in Arkansas, where seven insurers offer short-term plans.
Plans are available from two insurers in the Arkansas exchange, although they offer plans via various subsidiaries:
- Ambetter (including QualChoice and QCA Health Plan)
- Arkansas Blue Cross Blue Shield/USAble Mutual (PPO plans)
- Health Advantage/HMO Partners (POS plans). This is an affiliate of Arkansas Blue Cross Blue Shield
Oscar offered plans in Arkansas in 2022, but exited the state’s market at the end of 2022, after only offering coverage for one year.
According to the Arkansas Insurance Department and the federal rate review website, the proposed rate changes for 2023 were all approved as filed, with an overall weighted average rate increase of about 5.9%:
- Arkansas Blue Cross Blue Shield (USAble Mutual): 5.8% increase
- Ambetter (Celtic/Centene): 7.9% increase
- QualChoice Life and Health (now owned by Centene/Ambetter; plans are marketed as Ambetter): 3.1% increase
- QCA Health Plan (now owned by Centene/Ambetter; plans are marketed as Ambetter): 5% increase
- Health Advantage (HMO Partners; an affiliate of Arkansas Blue Cross Blue Shield): 5.3% increase
During the open enrollment period for 2023 coverage, 100,407 people enrolled in private plans through the Arkansas exchange. This was by far a record high; enrollment had never reached even 90,000 people in any prior year.
Although more than 383,000 people were enrolled in private plans through the Arkansas exchange as of 2022, 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 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-19 pandemic. Enrollment in Medicaid will gradually decline in 2023 and 2024, during the “unwinding” of the pandemic-era rules that prohibited states from disenrolling people from Medicaid.
Total Medicaid enrollment in Arkansas (including the Arkansas Works population as well as ARKids First) stood at 1,029,175 as of late 2022. This was 84% 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. There are more than 300,000 people enrolled under Medicaid expansion (Arkansas Health and Opportunity for ME, or ARHOME), and as of late 2022, total Medicaid/CHIP enrollment in the state was up about 84% 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 660,533 Arkansas residents enrolled in Medicare as of late 2022. About 38% 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.