Arkansasʼ unin­sured fall be­low U.S. rate

El Dorado News-Times - - Health & Wellness - By Andy Davis Arkansas Demo­crat-Gazette

The per­cent­age of Arkansans who lack health in­sur­ance con­tin­ued to drop last year, fall­ing be­low the na­tional rate for the first time since at least 2008, ac­cord­ing to the U.S. Cen­sus Bureau.

Ac­cord­ing to the bureau’s Amer­i­can Com­mu­nity Sur­vey, the num­ber of unin­sured Arkansans fell by al­most 46,000, to 231,775, in 2016.

As a re­sult, the per­cent­age of Arkansans who were unin­sured fell from 9.5 per­cent in 2015 to 7.9 per­cent.

Na­tion­wide, the num­ber of Amer­i­cans who re­ported they lacked cov­er­age fell by 8 per­cent, to 27.3 mil­lion, with the per­cent­age of Amer­i­cans who were unin­sured drop­ping from 9.4 per­cent to 8.6 per­cent.

Com­pared with other states, Arkansas ranked 25th in the per­cent­age of res­i­dents who had cov­er­age last year, an im­prove­ment from 30th in 2015.

“Those are strong num­bers for the state, and ac­tu­ally may rep­re­sent a first time ever on a health in­di­ca­tor that we are above the na­tional av­er­age,” Joe Thomp­son, di­rec­tor of the Arkansas Cen­ter for Health Im­prove­ment, said.

The im­prove­ment in Arkansas’ rate came as en­roll­ment con­tin­ued to in­crease in Arkansas Works, as the ex­panded part of the state’s Med­i­caid pro­gram is known.

In 2013, the year be­fore the ex­pan­sion took ef­fect, 464,590 Arkansans, or about 16 per­cent of the state’s res­i­dents, were unin­sured.

The ex­pan­sion ex­tended cov­er­age to adults with in­comes of up to 138 per­cent of the poverty level. Un­der this year’s guide­lines, that’s $16,643 for an in­di­vid­ual, or $33,948 for a fam­ily of four.

Dur­ing 2016, en­roll­ment among el­i­gi­ble adults grew by more than 70,000, to over 330,000.

This year, how­ever, the num­ber has fallen by about 24,000 amid an ef­fort by the Depart­ment of Hu­man Ser­vices to iden­tify en­rollees who are no longer el­i­gi­ble and re­move them from the pro­gram.

Con­cerned about the cost of the pro­gram, the state has re­quested fed­eral per­mis­sion to move off about 60,000 more peo­ple, start­ing next year, by lim­it­ing el­i­gi­bil­ity to peo­ple with in­comes be­low the poverty level.

Most of those af­fected are ex­pected to qual­ify for fed­eral tax sub­si­dies to buy pri­vate cov­er­age on the state’s health in­sur­ance ex­change.

Bo Ryall, chief ex­ec­u­tive of the Arkansas Hos­pi­tal As­so­ci­a­tion, said Med­i­caid ex­pan­sion has had a “tremen­dous im­pact” on hos­pi­tals — likely pre­vent­ing some from go­ing out of busi­ness — by re­duc­ing the amount of un­re­im­bursed care they pro­vide to the unin­sured.

If the state’s re­quest to scale back the ex­pan­sion is granted, hos­pi­tals will work with the Hu­man Ser­vices Depart­ment to en­cour­age those who are cut from the pro­gram to sign up for other cov­er­age.

“We’re def­i­nitely con­cerned about that,” Ryall said. “If we lose large per­cent­ages of that 60,000 group, if they do not trans­fer over and get the same type of in­sur­ance on the in­sur­ance mar­ket­place, they could end as the unin­sured and then ul­ti­mately un­com­pen­sated care for the hos­pi­tals.”

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