Arkansas (Again) Leads Nation In Uninsured Drop Since ACA

Aug 10, 2015

Health Care Task Force Chair, Senate Majority Leader Jim Hendren (R-Sulphur Springs) during a break in a July meeting.
Credit Jacob Kauffman / KUAR

The Affordable Care Act continues to help Arkansas - more than any other state in the nation - to reduce its percentage of uninsured residents. A survey released on Monday by Gallup shows Arkansas has cut its uninsured rate by more than half since the first provisions of the ACA went live in 2013.

The Gallup results show the state’s uninsured rate stands at 9.1 percent midway through the year. That’s 3.3 percent lower than midyear 2014 (also first in the nation) and well below 2013’s 22.5 percent uninsured rate.

Analysis Gallup contended states that implemented more optional components of the Affordable Care Act did a better job of covering more people.

“Collectively, the uninsured rate in states that have chosen to expand Medicaid and set up their own state exchanges or partnerships in the health insurance marketplace has declined significantly more since 2013 than the rate in states that did not take these steps.”

Arkansas is the only state in the South to expand Medicaid (private option) and its federal-state hybrid marketplace is building up to a state-based exchange in 2017. Both steps require further legislative action from a state legislature that has grown increasingly conservative and hostile to the programs.

Senate Majority Leader Jim Hendren (R-Sulphur Springs), who chairs the state’s Medicaid Task Force, told KUAR more coverage doesn’t necessarily equal good healthcare policy.

“I’ve said all along that if you spend $100 million a month on insurance premiums you’re going to make a dent in a state the size of Arkansas - with the number of uninsured. That’s mathematics and nobody can dispute that, and that’s a good thing,” said Hendren. “The question is, ‘how do we sustain it, is it sustainable, is it the best and most efficient way to deliver healthcare to those folks?’ That’s what the task force is trying to determine.”

Hendren said that the uninsured rate might even climb back up in the second half of the year as the state moves forward with verifying the incomes of Medicaid beneficiaries.

“If we end up re-determining and 40,000 to 60,000 people roll off of that, do I expect it to tick up? The math says it will,” said Hendren.

By the end of this month at least 47,000 people will have received Medicaid termination notices. The Department of Human Services has said verification letters will go out to about 40 percent of the state’s 600,000 Medicaid and private option beneficiaries. 97 percent of termination notices sent so far have been issued because Arkansans either failed to respond to the letter in a 10-day window - or - DHS failed to process the information before sending termination notices. Many of these people can resubmit information or re-apply in the next 90 days while others may qualify for subsidies in a special enrollment period for the healthcare marketplace.

Governor Asa Hutchinson last week ordered a two-week pause to termination notices in order to sort out an “overload of information” at DHS. The governor also lifted a hiring freeze at DHS, is reassigning other state personnel, and pursuing temporary staff to help catch up to backlog of unprocessed documents.

Arkansas Democrats, and a few Republican supporters of the private option, have criticized Governor Hutchinson for not extending the 10-day income verification window and for not taking a more pro-active role assisting those losing coverage to navigate to appropriate healthcare programs. 

The national uninsured rate dropped from 17.3 percent in 2013 to 11.7 percent through the first half of 2015. Rhode Island’s 2.7 percent is the lowest and with 20.8 percent uninsured Texans without coverage fare the worst. Arkansas’s border state neighbors all have higher uninsured rates, though all have seen declines in the uninsured since the ACA was enacted.