![]() These findings are similar to the experience of other states that have expanded coverage, regardless of the mechanism used to implement the Medicaid expansion.Įarly reports indicate that private option beneficiaries are receiving wrap-around protections for premiums and cost-sharing that exceed Medicaid limits, while access to wrapped benefits required by Medicaid but not covered in the Marketplace was more mixed. Community health centers also are seeing more insured patients, but some reported challenges due to delays in cost-based reimbursement payments from the state or noted that new clinics established by Marketplace plans could “skim off” their insured patients. Hospitals saw a 55 percent drop in uncompensated care costs and signs of people seeking care in more appropriate community-based settings instead of emergency rooms. ![]() Stakeholders reported that private option enrollees are generally able to access services, and hospitals are seeing sharp drops in uncompensated care, while the impact on community health centers is more mixed. Close to four in ten private option enrollees gained coverage for the first time in their lives, 1 and stakeholders reported that enrollees were able to access a broad set of services, including specialty care and providers in rural areas. Since these renewal issues are not specific to private option enrollees and arose after the interviews for this brief were completed, they are not addressed in any detail. Since the time of our interviews in the spring of 2015, Arkansas has been confronting operational challenges in conducting renewals in traditional Medicaid and for the private option. Arkansas’ use of fast track enrollment strategies, by using SNAP data to identify beneficiaries eligible for the private option, contributed to strong early enrollment in the program. The marked increase in coverage in Arkansas occurred despite limits on funding for outreach and enrollment, eligibility computer system issues, and confusion among some beneficiaries about where to seek enrollment assistance. These gains are consistent with the experience of states that expanded coverage through their traditional Medicaid programs. Key findings include the following:Īrkansas cut its uninsured rate among non-elderly adults nearly in half (from 27.5 percent to 15.6 percent) between 20. This reduction, the second largest percentage point decline nationally, was realized in large part due to the coverage pathway offered through the private option as Arkansas had the lowest eligibility threshold for adults in the country prior to 2014. Drawing on a dozen interviews with state officials, providers, insurance carriers, and advocates, as well as early data on coverage, reduced uncompensated care costs, and other topics, this issue brief provides an initial look at implementation. ![]() The future of the private option is the source of extensive discussion within Arkansas, and it continues to be watched closely by policymakers within the state and around the country. As a result of this coverage, Arkansas has been able to drive down its uninsured rate and reduce uncompensated care costs. An additional 25,000 medically frail adults are covered through the state’s fee-for-service system, bringing to 245,000 the number of newly eligible adults covered in Arkansas as of June 30, 2015. The initiative, often referred to as the “private option,” has allowed Arkansas to cover close to 220,000 Medicaid beneficiaries with commercial provider networks and strengthen its Marketplace. In September 2013, Arkansas became the first state in the nation to receive approval from the federal government for a Section 1115 demonstration waiver to require most adults who are newly eligible for coverage through the Affordable Care Act’s Medicaid expansion to enroll in Marketplace plans.
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