Explainers

Coverage Expansion Timeline for Adults in Arkansas

January 1, 2018

Contact

Craig Wilson, JD, MPA
Director, Health Policy
501-526-2244
cwilson@achi.net

 

In 2013, Arkansas opted to expand healthcare coverage to low-income adults earning below 138 percent of the federal poverty level (FPL) through the Patient Protection and Affordable Care Act (ACA). The program, now known as Arkansas Works, used federal funds allotted for Medicaid expansion under the ACA to purchase qualified health plans (QHPs) available in the Health Insurance Marketplace (HIM). This timeline of significant events describes the life of the Arkansas Works program, including its development, programmatic changes, and legislative history.

Key takeaways

  • Colloquially known as the “Private Option,” the “Health Care Independence Program” (HCIP) used federal funds allotted for Medicaid expansion under the ACA to purchase qualified health plans (QHPs) available in the Health Insurance Marketplace (HIM).
  • During the life of the waiver, HCIP underwent modifications in response to legislative amendments to the enabling bill—The Health Care Independence Act—including the introduction of health independence accounts (HIAs) to incorporate personal responsibility and limitations on use of non-emergency transportation.
  • Prior to expiration of HCIP on Dec. 31, 2016, Arkansas sought and received approval for a waiver extension to continue the premium assistance model, renamed “Arkansas Works.”
  • The five-year waiver extension included requirements for premium payments for individuals earning between 101 and 138 percent of the FPL and an employer-sponsored health insurance (ESI) premium assistance program.
  • In 2017, additional modifications to Arkansas Works were legislatively enacted, including eliminating the ESI premium assistance program, capping program eligibility at 100 percent of the FPL, and adding a work requirement as a condition of eligibility. The waiver amendment modifications are anticipated to take effect through a phased process upon approval in 2018.