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Medicaid, SCHIP, & Federal Authority

  • Health Insurance Flexibility and Accountability (HIFA) Waiver – On March 3, 2006, Arkansas received approval for their HIFA initiative, the Arkansas Safety Net Benefit Program, designed to increase health insurance coverage through a public/private partnership that will provide a ‘safety net’ benefit package to approximately 50,000 uninsured working individuals over 5 years. Recently renamed ARHealthNet, the program will provide coverage to adults who work for employers who agree to participate in the demonstration and meet participation requirements. Eligible are parents and spouses of Medicaid and State Children’s Health Insurance Program (SCHIP) children and childless adults aged 19-64 who do not have other insurance coverage, are ineligible for Medicaid or Medicare, and have family incomes at or below 200 percent of the federal poverty level (FPL). Employees with incomes above 200 percent of the FPL may also elect ARHealthNet coverage; however, such individuals do not receive subsidized premium assistance.  The demonstration will occur in two phases, with Phase I (years one and two) being capped at 15,000 parents and childless adults. Phase II will begin in year three and will target approximately 35,000 parents and childless adults.

    Section 1115 Waiver - In 1997, Arkansas received approval for a Medicaid 1115 waiver for their ARKids B program. The waiver expanded eligibility to currently uninsured children through age 18 with family incomes at or below 200 percent of the FPL. ARKids B included a reduced benefit package, modeled on the Arkansas State Employee and State Teachers plans. The benefits have some limitations on Early Periodic Screening, Diagnosis, and Treatment (EPSDT) services, inpatient mental health services, transportation, and therapy services.


High-Risk Pools

  • The Arkansas Comprehensive Health Insurance Pool was created in 1996 as a state program that was intended to provide an alternative market for health insurance for certain uninsurable Arkansas residents and to provide the acceptable alternative mechanism as described in the Health Insurance Portability and Accountability Act (HIPAA) of 1996 for providing portable and accessible individual health insurance for federally eligible individuals. The premium cap for the pool is set at 150 percent of market rate for comparable coverage. At the end of June 2006, approximately 2,900 people were enrolled in the pool.


Limited-Benefit Plans

  • The Health Insurance Consumer Choice Act of 2001allowed health insurers and HMOs to offer health insurance plan options to consumers that include all, some, or none of the Arkansas coverage mandates; and requires certain disclosures to be made to consumers so they may make a fully informed choice of offerings. In addition, the legislation authorizes the Insurance Commissioner to issue rules or regulations to help reduce the cost of insurance and decrease the number of uninsured Arkansans.


Group Purchasing Arrangements

  • The Small Employer Health Insurance Purchasing Group Act of 2001 allowed the formation of health insurance purchasing groups for the purpose of buying health insurance. This legislation allows health insurers to offer options to consumers participating in the purchasing group that include all, some, or none of the Arkansas coverage mandates and contains some actuarial protections to minimize the concern of anti-selection.

    On January 1, 2005, the first health insurance purchasing group in Arkansas was initiated. Administratively housed within and sponsored by the North Little Rock Chamber of Commerce, businesses with fewer than 100 employees and not currently offering health insurance who band together may negotiate coverage with health insurance carriers.