With most of the Affordable Care Act’s major provisions now in effect, the nation’s health insurance marketplace has undergone a significant transformation. Obamacare impacts individuals, families and small business owners alike. Most Americans are required to have minimum essential coverage unless they qualify for an exemption; however, the law is designed to make health insurance more accessible and affordable with income-based financial assistance and one-stop shopping via state-based health insurance marketplace and federally facilitated exchanges. Meanwhile, the private marketplace remains a place to shop for quality, affordable health insurance plans that meet ACA requirements.
The following guide offers a glimpse at the health insurance marketplace in Arkansas, including individual and family health plans, small group health plans, coverage for high-risk applicants, mini-COBRA continuation coverage, Medicaid, and CHIP.
Health and healthcare in Arkansas
The Department of Health and Human Services reported that 43,446 individuals in Arkansas selected a health insurance marketplace plan through the exchange from Oct. 1, 2013, through April 19, 2014.1 In 2015, the number of individuals in Arkansas enrolled in a marketplace plan increased to 65,684 during the open enrollment period.2
Arkansas ranked 49th in United Health Foundation’s 2014 America’s Health Rankings.3 As a state, its strengths included a low prevalence of binge drinking, high per capita public health funding, and a small disparity in health status by educational attainment. However, Arkansas struggles with high prevalences of smoking, obesity and physical activity; low immunization coverage among adolescents; and limited availability of dentists.
Arkansas individual and family health insurance
When the Obamacare Health Insurance Marketplace opened for business Oct. 1, 2013, Arkansas was among the few states that chose a partnership exchange. The state of Arkansas assumes plan management functions as well consumer assistance and outreach; application and enrollment take place at the federal health insurance marketplace website Arkansas plans to transition to a private, nonprofit state-based health insurance exchange by July 1, 2015.4
Those who buy health insurance through Arkansas’ exchange may be eligible for income-based subsidies, including premium tax credits that may be applied to any metal plan and cost-sharing subsidies that apply to silver plans. Individuals who go without health insurance may face a tax penalty known as the shared responsibility payment.
Arkansas residents can also buy qualified health insurance plans in the private marketplace through websites such as HealthCare.com. To find out if you qualify for an Obamacare tax credit, use HealthCare.com’s tax subsidy calculator. If you are eligible for financial assistance, visit Arkansas Health Connector to get more information on the state’s Obamacare health insurance options and then visit the Federal Health Insurance Marketplace to shop and enroll.
|Arkansas’ health insurance exchange Information:||Arkansas Health Connector|
|Arkansas department of insurance:||insurance.arkansas.gov|
Arkansas small group health insurance plans
Small businesses with 50 or fewer employees may purchase small group health insurance plans through the federally facilitated Small Business Health Options Program marketplace, at healthcare.gov/marketplace/shop and in the private marketplace. Small businesses that use SHOP and have 25 or fewer employees may qualify for a Small Business Healthcare Tax Credit.
Arkansas’ small business owners may also find small group health insurance in the private marketplace through websites such as such as HealthCare.com. Self-employed individuals with no employees must apply for an individual health insurance plan on or away from the state’s exchange.
Arkansas state COBRA variations for small groups
The Consolidated Omnibus Reconciliation Act (COBRA) allows those employed by businesses with 20 or more employees to continue their group health insurance plan for a limited time should they lose coverage due to qualifying events such as termination of employment due to reasons other than gross misconduct, a reduction in work hours, divorce or legal separation, and loss of dependency status. To learn more about the federal COBRA program, visit dol.gov/ebsa/cobra.html.
In some states, those who work for a small business and lose health insurance coverage due to a qualifying event may be eligible for health insurance continuation through mini-COBRA or a similar state continuation program. In a few states, these programs may also be extended to those who work for larger companies and exhaust their federal COBRA continuation coverage limit. Mini-COBRA generally works like the federal COBRA continuation coverage, but its terms may vary.
Arkansas’ small group COBRA continuation variations are as follows:
|Eligible group sizes||2 to 19|
|Maximum continuation period – standard||120 days|
|Maximum premium Increase||100 percent|
|State legislation reference||Arkansas Code of 1987 – Title 23, Chapter 86 (Section 23-86-114, 23-86-115, 23-86-116)|
|More Information||800-852-5495 – Arkansas Insurance Department Consumer Services Division|
|Additional notes||Individuals and qualified dependents must have been insured under the policy for at least 3 months prior to the date of termination.Employees must request continuation for themselves and their dependents within 10 days after termination of employment.|
Arkansas high-risk pools
It used to be that health insurance companies could deny applicants or charge them more based on health history and preexisting conditions. When the Affordable Care Act was passed in 2010, many states created federally funded preexisting condition insurance programs or accepted federal funding to assist with similar high-risk pool programs they already operated.5
The Affordable Care Act prohibits this practice for health insurance plans considered minimum essential coverage with effective dates beginning Jan. 1, 2014, and later. As such, the PCIPs and state high-risk pools created to provide health insurance for those once considered uninsurable are being phased out.
Arkansas’ federally run PCIP program ended April 30, 2014.6 The state’s high-risk pool, Arkansas Comprehensive Health Insurance Pool, ended Dec. 31, 2013.7
Medicaid is a state health insurance program for low-income individuals under age 65, pregnant women, children, disabled individuals, and seniors over age 65; it is partially funded by the federal government. In 2014, states were given the option to accept additional federal funding and expand their Medicaid program eligibility to those who make up to 133 percent of the federal poverty level (effectively 138 percent due to how it is calculated, according to HealthCare.gov).8
Arkansas expanded its Medicaid program in 2014; however, the state used what is called the “private option”9 10 The state will use Medicaid funds to buy private health insurance for its more than poor residents. The expansion drew controversy in September 2014 when the U.S. General Accountability Office reported Arkansas’ private option would cost taxpayers an extra $778 million dollars over the next three years rather than being “revenue-neutral” to the federal budget.11
The information below is specific to Arkansas’ Medicaid program:
|Governing agency||Centers for Medicare & Medicaid|
|Administrator||Arkansas Department of Human Services|
|How to apply||HealthCare.gov / medicaid.state.ar.us/InternetSolution/consumer/howapp.aspx|
|Eligibility||Arkansas resident, U.S. citizen, qualified non-residents; covered services vary by category and program|
|Open-enrollment period||Year-round in all states|
The Children’s Health Insurance Program is a partnership between the states and federal government. CHIP provides health insurance to uninsured children who meet certain eligibility guidelines.
The information below is specific to Arkansas’ health insurance program for low-income children:
|How to apply||arkidsfirst.com/apply.htm|
|Eligibility17||Based on income|
1 Kaiser Family Foundation http://kff.org/other/state-indicator/state-marketplace-statistics-2014/.
2 Kaiser Family Foundation http://kff.org/other/state-indicator/state-marketplace-statistics-2015/.
3 United Health Foundation. 2014 America’s Health Rankings Annual Edition. “Annual State Health Rankings.” http://www.americashealthrankings.org
4 Arkansas Insurance Department. Arkansas Health Connector. “About Us.” AHC.Arkansas.gov. N.D. Retrieved from http://ahc.arkansas.gov/about-us/.
5 National Conference of State Legislators. Coverage of Uninsurable Pre-Existing Conditions: State and Federal High-Risk Pools. Updated April 2014. Retrieved from http://www.ncsl.org/research/health/high-risk-pools-for-health-coverage.aspx.
7 Arkansas Comprehensive Risk Pool. Home page. N.D. Retrieved from http://www.chiparkansas.org.
8 Centers for Medicare & Medicaid Services. “Medicaid Expansion & What It Means for You.” HealthCare.gov. N.D. Retrieved from https://www.healthcare.gov/what-if-my-state-is-not-expanding-medicaid/.
9 Centers for Medicare & Medicaid Services. “Arkansas.” Medicaid.gov. N.D. Retrieved from http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/arkansas.html.
10 Kissel, Kelly P. Associated Press. “Correction: Arkansas Medicaid-GAO Report Story.” The Washington Times. Sept. 10, 2014. Retrieved from http://www.washingtontimes.com/news/2014/sep/10/gao-arkansas-medicaid-plan-not-revenue-neutral/?page=all.