LITTLE ROCK — Arkansas has led the nation in reducing its percentage of residents without health insurance since the federal Affordable Car Act began requiring most adults to have health insurance, according to a new Gallup survey.
The survey released Tuesday found that Arkansas’ uninsured rate has been cut nearly in half, dropping from 22.5 percent at the end of 2013 to 12.4 percent at the end of June — a reduction of 10.1 percentage points.
The Affordable Care Act’s mandate that adults have health insurance took effect Jan. 1. The law also required the creation of insurance marketplaces, or exchanges, where people and small businesses can shop for insurance plans. While some states chose to run their own exchanges and some chose to let the federal government run theirs, Arkansas opted for a state-federal partnership.
The law initially called for states to expand their Medicaid rolls to cover residents earning up to 138 percent of the federal poverty level, but the state Supreme Court ruled that the federal government could not penalize states that did not comply, effectively making that provision optional. Arkansas obtained federal permission to implement an alternative program known as the “private option,” which uses federal Medicaid money to subsidize private insurance for the Medicaid expansion population.
By the end of June, 176,691 Arkansans had enrolled in the private option, according to the state Department of Human Services. As of July 6, an additional 41,393 Arkansans were enrolled in plans through the insurance marketplace outside of the private option, although 3,000 of those plans have since been canceled for various reasons, according to the state Insurance Department.
The Gallup survey found that the 10 states with the largest declines in uninsured rates all have state-run or partnership exchanges and have adopted some form of Medicaid expansion.
Those states are, in descending order: Arkansas with a drop of 10.1 percentage points; Kentucky, 8.5; Delaware, 7.2; Washington, 6.1; Colorado, 6; West Virginia, 5.7; Oregon, 5.4; California, 5.3; New Mexico, 5; and Connecticut, 4.5.
Gallup noted that Oregon’s legislature recently voted to switch from a state-based exchange to a federal-based exchange.
A total of 21 states have both a state-run or partnership exchange and some form of Medicaid expansion. Those states combined saw a 4 percent drop in their uninsured rates in the first half of 2o14, whereas the 29 states with only one or neither saw a 2.2 percent drop, according to the survey.
Nationally, 17.3 percent of adults reported having no health insurance in 2013, but by the middle of 2014 that percentage had dropped to 13.4 percent, Gallup reported.
The survey was conducted via phone interviews with 178,068 adults in 2013 and 88,678 adults in the first half of 2014. The margin of error is plus or minus 1 or 2 percentage points for most states.
Gov. Mike Beebe said in a statement Tuesday, “When we worked with the Arkansas Legislature to pass the private option, we said it would make Arkansas a national leader for innovative health care solutions, and this report proves that to be true. Even though not everyone was happy with the circumstances surrounding the Affordable Care Act in our state, we showed that we could find a bipartisan path to make the best of the situation and help our people.”
Beebe said that in 2013, Arkansas ranked next to last among states for its uninsured rate, with only Texas having a higher rate of uninsured residents, but six months into 2014, Arkansas has surpassed half the country and is now tied for 22nd with New Hampshire.
The private option was crafted by a group of Republican legislators but has been a divisive issue for the GOP, with a number of Republican lawmakers questioning whether the program will be affordable when the state begins paying a portion of the cost in 2017. Renewed appropriation of federal funding for the program will require three-fourths votes in both chambers of the Legislature next year.
Senate President Pro Tem-designate Jonathan Dismang, R-Beebe, one of the architects of the program, said Tuesday the drop in Arkansas’ uninsured rate is “a very significant shift and one we should be proud of.”
But Dismang added, “One of the major factors that people are looking at is whether or not this is something that we can afford as a state, and I think that question is still yet to be answered. In reality we’ll be waiting on the actual numbers, which we hope to have in the fall, of what the true cost of the program is.”