More on Arkansas Works, Medicaid; Blue Cross says its numbers steady

The higher COVID-19 pandemic-related unemployment rate likely will result in significant changes to the way Arkansans have health coverage, a health policy organization says.

So far, the numbers show that more Arkansans were accessing Arkansas Works and Medicaid in May than did in April. However, few have lost coverage at Arkansas Blue Cross Blue Shield, a spokesperson for the insurer said.

The Arkansas Center for Health Improvement (ACHI), a health policy organization, predicts a shift in coverage with the unemployment rate in Arkansas rising from a revised 5.0% in March to 10.2% in April. The State Health Access Data Assistance Center says 147,000 Arkansans could experience a disruption in employer-sponsored health insurance.

The number of Arkansans enrolled in Arkansas Works rose to 261,975 at the beginning of May, an increase of 11,639 over April’s first day. Previously, the number had been relatively flat since December 2019.

Arkansas Works is the state program that uses federal Medicaid dollars under the Affordable Care Act to purchase private health insurance for Arkansans with incomes up to 138% of the federal poverty level, or $17,609 annually for individuals and $36,153 for a family of four. The state covers 10% of the program’s cost.

Total spending on Arkansas Works will rise from $2.06 billion in state fiscal year 2020 to $2.524 billion in 2021 – an increase of $464 million. The state’s share is increasing from $175.1 million to $252.5 million, or $77.4 million.

Senate Majority Leader Jim Hendren, R-Gravette, said in a text Friday (June 5) that legislators built an increase into the Department of Human Services budget knowing it would be affected by the pandemic.

As for next year’s regular session, Hendren said, “I’ve not heard a lot of discussions about it yet, but I’m certain it is something we will have to take a look at in January.”

Craig Wilson, ACHI’s health policy director, said Arkansas’ citizens are in a better position to access coverage than those living in surrounding states that didn’t expand their Medicaid populations under the Affordable Care Act. Arkansas created the program now known as Arkansas Works. Louisiana also expanded its Medicaid population. The rest of the states adjacent to Arkansas did not.

Total Medicaid enrollment also grew, increasing 22,920 in one month to 926,015 as of May 1. Previously, it had changed little since September 2019.

The number of people losing coverage through Arkansas Blue Cross Blue Shield has been modest and mainly due to business closures, said Max Greenwood, a spokesperson. The company made a decision not to cancel any individual or group member policies because of failure to pay premiums.

“We understand this is a difficult time for many of our members and we will continue working with them to try to help them keep their health care coverage,” she said.

She said Blue Cross is monitoring the situation and watching for trends even though much is unknown, including the pandemic’s trajectory. Insurers will be affected differently based on geography, the pandemic’s severity, their policyholder mix, the businesses they cover and other factors. Deferred medical care will eventually have to be provided, and the company has been encouraging members to seek treatment they have delayed, she said.

Nationally, the unemployment rate fell from 14.7% in April to 13.3% in May, the U.S. Bureau of Labor Statistics said Friday, although there is some dispute about the classification of about 3% of temporarily laid-off workers. The Bureau said in its press release that labor market improvements reflected a resumption in economic activity following the nationwide shutdowns that occurred in March and April. It said employment rose “sharply” in the leisure and hospitality, construction, education and health services, and retail trade sectors.

ACHI’s Wilson noted that some of those sectors often do not provide job-based health insurance.

The unemployment rate is still up 9.8%, or 15.2 million people, since February, when the unemployment rate was 3.5%. Figures for May were not yet available for Arkansas.

The current breakdown of coverage according to ACHI and state government sources is as follows:

– Private insurance: 1.2 million
– Traditional Medicaid, including ARKids A: 720,000
– ARKids B, which is for families who do not qualify for Medicaid and unlike ARKids A requires a co-payment for some services: 33,000
– Medicare: 646,000
– Arkansas Works: 261,975
– Arkansas Health Insurance Marketplace: 59,319
– Uninsured: 300,000

The Arkansas Health Insurance Marketplace allows individuals to purchase federal government-subsidized health insurance under the Affordable Care Act. Subsidies are available for individuals whose incomes are between 139% and 400% of the federal poverty rate on a sliding scale, or up to $51,040 for an individual and $104,800 for a family of four.

Individuals typically enroll in the program from Nov. 1 through Dec. 15, but they are eligible for a special enrollment period if they have a “qualifying life event” including losing job-based or individual health coverage.

Enrollment always peaks on January 1 and then falls throughout the year as individuals’ lives change, they obtain job-based insurance or they don’t pay their bills, Arkansas Insurance Department spokesperson Ryan James said. In 2019, enrollment was 62,610 in January and then fell to 51,383 in December.

This year, enrollment was 63,460 in January and began falling, but unlike last year, it leveled off in March and April and then actually rose in May before falling again in June. Enrollment this month is 59,319, compared to 56,562 in June 2019.

James said the department doesn’t have data to confirm that the pandemic caused the leveling off, but the timing would suggest it.