(July 12, 2013) – Beginning Oct. 1, more than 500,000 Arkansans who are newly eligible for affordable health insurance under the 2010 Patient Protection and Affordable Care Act can choose the plan that best fits their budgets and family needs.
The goal of the federal law, also known as the Affordable Care Act, is to ensure that Americans have access to affordable, quality health insurance beginning Jan. 1, 2014. Each state can choose how it will implement the federal law, and Arkansas has emerged as a trailblazer for its approach. The state has created the Arkansas Health Connector and partnered with the federal government to offer private-carrier plans through the Insurance Marketplace.
“Every family has different needs, and with more than half a million Arkansans without health insurance, a ‘one size fits all’ solution just won’t work,” said Cynthia Crone, deputy insurance commissioner in charge of implementing the Marketplace in Arkansas. “We needed something that could be tailored to fit each person’s specific needs. That’s where the Arkansas Health Connector comes in.”
Under ACA, about 500,000 Arkansans will be eligible for private insurance that must cover federally mandated health benefits ranging from inpatient and outpatient services to prescription services and maternity care. The new law also provides financial assistance, based on income, that will help residents purchase the health insurance. In some cases, the financial assistance could cover the entire cost of the insurance.
The Arkansas Health Connector, the state’s guide to all things ACA, is a preparatory tool for users. The Marketplace is where individuals, families and small employers can compare private health insurance plans and shop for coverage.
The Marketplace will also provide access to tax credits that help lower- and middle-income individuals pay for coverage. The financial assistance will reduce out-of-pocket costs – such as deductibles, coinsurance or payments – when they receive healthcare services.
The Health Connector website, ARHealthConnector.org, launched July 1 and features an in-depth Frequently Asked Questions section, as well as a cost estimator and links to other helpful resources.
Insurance plans available through the Marketplace will be ranked on a tiered system similar to Olympic medals: Bronze, Silver, Gold and Platinum. The plans, offered by private insurance carriers, will not be available for viewing until Oct. 1 when open enrollment begins, continuing through March 31. Plans differ in cost based on the share the patient wants to pay for healthcare. For example, a Bronze plan covers 60 percent of the cost of the essential health benefits, while the patient pays 40 percent. By comparison, the Platinum plan covers 90 percent of the cost, leaving the patient to pay 10 percent.
The 10 Essential Health Benefits are:
- Preventive and wellness services and chronic disease management
- Outpatient services
- Emergency services
- Maternity services and newborn care
- Mental health and substance abuse disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services
- Laboratory services
- Pediatric services, including dental and vision care.
“Think of the 10 Essential Health Benefits as the Bill of Rights for health insurance,” Crone said. “We believe that if every Arkansan has access to these services or a combination of these services, lives will be saved and the cost of healthcare will go down.”
Arkansas is the first state to pursue what’s been called the Private Option, formally known as the Arkansas Health Care Independence Act. The Private Option calls for federally funded premium payments to private insurers and other savings for Arkansans who are newly eligible for Medicaid under the ACA. In this way, it does not expand the existing Medicaid program to include another 250,000 Arkansans, yet allows them to begin signing up for healthcare plans through the Marketplace beginning Oct. 1.