Arkansas health insurance marketplace: history and
news of the state’s exchange

BCBS of Arkansas and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

More Arkansas coverage

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    • Insurance for those over 64

Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

Arkansas exchange overview

In 2018, 68,100 people enrolled in private plans during open enrollment which was 2% lower than the previous year. After the Affordable Care Act, the uninsured rate declined by 50% in just three years. A large part of reducing the uninsured rate is attributed to the expansion of Medicaid in the state under the Arkansas works program. As of January 2018, there were 285,000 people enrolled in Arkansas Works program. However, in March of 2018 the state issued a work requirement for the program which will most likely decrease the number of people eligible for the program. The same proposal wanted to reduce the income cap for Medicaid eligibility from 138% of the poverty level to 100% of the poverty level but the CMS rejected this allowing a significant number of people to remain in the program and insured.

Health Ratings

In 2017, Arkansas was rated 48th on the Scorecard on State Performance. This scored was measured using five categories:

  • Access
  • Prevention and Treatment
  • Avoidable Hospital Uses and Costs
  • Healthy Lives
  • Equity

Arkansas scored highest in the Prevention and Treatment category coming in at 40th place. The state scored low in Healthy Lives and Equity ranking 48th. Furthermore, they ranked 51st (the lowest) when it came to the number of non-elderly whose medical costs were considered unaffordable.

In America’s Health Ranking, Arkansas ranked 48th coming in just before Louisiana and Mississippi. Arkansas may have a high public health funding but where it lacks is access to dentists, primary care physicians, lack of insurance, and childhood immunization rates. In Arkansas, the physician to patient ration was 1,540 to 1.

Carriers and Enrollment in Arkansas

There are four carriers offering plans in 2018 in Arkansas:

  • Arkansas Blue Cross Blue Shield (USAble Mutual)
  • Celtic Insurance Company (Ambetter)
  • QualChoice
  • QCA Health Plan

It was estimated that 65,684 people enrolled in private health care plans through in Arkansas which is only 26% of the estimated eligible market.


Private Option for Medicaid

Arkansas was the first state to receive federal funding for Medicaid expansion through the Private Option. The CMS gave Arkansas three year to test out their Private Option which is now called Arkansas Works. This allowed Arkansas to charge premiums for those above poverty level as well as capping Medicaid at 100% of the poverty level. In March of 2018, the CMS approved a work waiver for the state of Arkansas as well as Kentucky and Indiana. The CMS also approved a 30-day retroactive coverage provision—this will allow recipients to be covered 30 days before the application date.


Arkansas Risks

The Arkansas Comprehensive Health Insurance Pool was enacted in 1996 which gave another health coverage option for those who aren’t able to purchase individual health insurance due to a pre-existing condition. As a result of the Affordable Care Act, the need for high risk pools in Arkansas is no longer an issue.

Arkansas and Medicare

Arkansas has one of the highest percentages of Medicare participants who qualify for disability at 23% while the other 77% qualify on age. In Arkansas, Medicare spends around $8,509 per recipient annually. For those recipients who want additional coverage, they can opt for the Medicare Advantage plan. Across the United States, 33% of recipients opt for the Medicare Advantage.


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 Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.