In June 2012 the U.S. Supreme Court’s ruling allowed states to decide whether to extend Medicaid benefits to their citizens who qualify under the Patient Protection and Affordable Care Act (PPACA) expansion. Through a Section 1115 demonstration waiver, Arkansas utilized premium assistance to secure private health insurance offered through the individual health insurance marketplace (the Marketplace) for those between 19 and 64 years of age with incomes at or below 138 percent of the federal poverty level (FPL). The Health Care Independence Program (HCIP),commonly referred to as the “Private Option,” provided coverage to over 225,000 low-income Arkansans through 2015.
A component of the waiver’s terms and conditions is a required evaluation of differences in access, quality, outcomes, and efficiencies achieved through the use of commercial coverage for the low-income expansion population. The evaluation examines differences in both effects and costs through commercial premium assistance compared to the experience that would have been achieved through a traditional Medicaid expansion as a principal outcome of interest for the demonstration.
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