With respect to Medicaid expansion as envisioned by the Patient Protection and Affordable Care Act, Arkansas took a much different approach than other states. Rather than opting to expand the traditional Medicaid program for adults with incomes up to 138 percent of federal poverty level (FPL) as provided by the law, Arkansas decided to use that federal funding to allow those individuals to purchase private insurance through the Health Insurance Marketplace (HIM). Commonly called the “private option,” the Arkansas 89th General Assembly passed the Health Care Independence Act of 2013 (the “Act”) that authorized the use of the federal funding for this purpose.
Individuals eligible for the Health Care Independence program will have the entirety of their premium paid by the program. Those with incomes at or below 100 percent of FPL will also have any cost sharing paid by the program. Those with incomes from 101 percent to 138 percent of FPL will have minimal cost sharing with a maximum out-of-pocket cap on cost sharing at 5 percent of household income. Individuals who have exceptional health care needs and whose care may be better coordinated through traditional Medicaid will be screened out of the program and provided with services through Medicaid.
Estimates indicate that as of October 2013 approximately 250,000 individuals could be eligible for coverage through the program. The Act requires the Arkansas Department of Human Services in future years to seek waivers from the federal government to establish health savings accounts and to transition the ARKids B population into the program.
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