State Coverage Initiatives
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Overview of Medicaid and SCHIP Coverage

Group Income Eligibility
Children 200% FPL
Pregnant Women 200% FPL
Parents 15% FPL
All Adults (Safety Net Benefits Program) 200% FPL
SSI Disabled (non-elderly) 74% FPL

Medicaid, SCHIP, and Federal Authority2

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 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 FPL. 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.

To learn more about the Arkansas Safety Net Benefit Program, read SCI's HIFA Waiver Comparison Chart.

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 FPL. ARKids B included a reduced benefit package, modeled on the Arkansas State Employee and State Teachers plans. The benefits have some limitations on EPSDT diagnostic and treatment services, inpatient mental health services, transportation, and therapy services.

High-Risk Pool  

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 Plan  

The Health Insurance Consumer Choice Act of 2001 allowed 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 to band together may negotiate coverage with health insurance carriers.

Sources of Health Insurance Coverage State Data 2004-2005, U.S.

Notes and Sources

 

Percentage of Private-Sector Establishments That Offer Health Insurance Based on Firm Size by State, 2004

Information presented in the profile was summarized in December 2006 from a review of state Web sites and reports, and through contacts with state officials. In most cases the profiles were reviewed by state officials; however, it is possible that states have implemented strategies that are not reflected in this profile.

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1 This overview provides a general description of state coverage levels under their Medicaid and SCHIP programs, including coverage through waivers, as of October 2006. Health Management Associates researched eligibility information from state web sites, data from state reports, and verified through contacts with state officials during the fall of 2006. This does not reflect the specific eligibility categories or requirements. This is not intended to be a substitute for eligibility information provided by each state. Individuals interested in applying for these programs should contact the state directly for specific eligibility requirements.

2 The profile only includes Medicaid and SCHIP waivers intended to make comprehensive expansions to the uninsured. At this time, the profiles do not include Family Planning, Pharmacy Plus waivers, or long-term care waivers.

3 Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2005 and 2006 Current Population Survey.

4 Agency for Healthcare Research and Quality, Center for Financing, Access and Cost Trends. 2004 Medical Expenditure Panel Survey-Insurance Component.
 
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