Establishing the Exchange
On December 2, 2011, the Arkansas Insurance Department announced planning efforts for the Arkansas Health Benefit Exchange had ended due to legislative opposition which left the state unable to meet the federal timetable for implementation.1 Governor Mike Beebe (D) then endorsed the idea of a federal-state partnership exchange.2 Soon thereafter, the Insurance Department began to plan for a partnership exchange, releasing details of the model in January 2012, which suggested the state could choose to operate and receive federal funding for plan management and consumer assistance functions.3
Prior to the announcement halting state-run exchange planning, the Governor had directed the Insurance Department and the Insurance Commissioner to spearhead the state’s planning efforts. The Insurance Commissioner appointed the Arkansas Health Benefits Exchange Steering Committee to coordinate the planning process and integrate input and analyses from workgroups, stakeholders, and background analyses.4 The 21-member Committee included state officials, and representatives of health insurers and health care facilities, and consumer advocates.5 Six exchange planning workgroups with over 125 members met monthly with distinct focus areas: consumers, the health care industry, information technology, outreach, community, and state agencies. A self-chartered industry health care reform advisory group led by Arkansas Blue Cross Blue Shield also submitted feedback to these workgroups. The state also collected stakeholder feedback through community meetings, key informant interviews, a web-based survey, and in October, the Insurance Department held a Health Benefit Exchange Stakeholder Summit to discuss exchange options.6
Legislation to establish an exchange had been introduced during the 2011 legislative session, but all four bills were either withdrawn or failed at the close of the legislative session (HB 2138, SB880, SB904, HB2104).
Exchange Funding
The Arkansas Insurance Department received a federal Exchange Planning grant of almost $1 million in 2010. In September 2011, Governor Beebe contemplated applying for a Level One Establishment grant but declined after hearing lawmakers’ objections.7 A few months later however, the state submitted an application for $7.6 million in federal funding to implement the federal-state partnership exchange.8 In February 2012, the grant was awarded and Arkansas plans to use the funds to design and implement automation to connect Arkansas Medicaid and state-run exchange functions to the federally-facilitated eligibility and enrollment portal, implement systems to support state-operated consumer assistance functions, and develop plan management functions of the federally facilitated exchange.
Next Steps
Since their announcement to forgo a state-run exchange, Arkansas has been moving quickly to define what role the state will play in a federal- state partnership exchange. It is likely the state will maintain flexibility and control over insurance plan selection, rating, monitoring and consumer assistance functions including outreach, education, and a Navigator program. In early 2012, the Insurance Department issued two Requests for Proposals (RFPs) for subcontractors to assist with the development of requirements related to qualified health plan certification and the Navigator program.9,10 The Department also released an RFP for the installation of an information technology system for the state’s Navigator program.11
Additional information about Arkansas’ Health Benefit Exchange planning can be found at: http://www.hbe.arkansas.gov/
1. ‘State-run Health Insurance Exchange No Longer an Option.’ Arkansas Insurance Department News Release. December 2, 2011.
http://insurance.arkansas.gov/Administration/newsreleases/PR2011_12_02.pdf
2. Governor Beebe’s weekly column and radio address: Protecting Arkansas Insurance Consumers. December 22, 2011.
http://governor.arkansas.gov/newsroom/index.php?do:newsDetail=1&news_id=3222
3. Federal Exchange Partnership Model for Arkansas. January 30, 2012.
http://hbe.arkansas.gov/FederalPartnershipModel.pdf.
4. Arkansas Health Insurance Exchange Planning, Quarter 3 Report. (4/1/2011-6/30/2011)
http://www.hbe.arkansas.gov/QR7.11.pdf
5. Arkansas Health Benefits Exchange Steering Committee Members.
http://www.hbe.arkansas.gov/Steering/Members.html (Accessed October 14, 2011)
6. Agenda for Arkansas Health Benefits Exchange Stakeholder Summit. October 11, 2011.
http://hbe.arkansas.gov/SummitAgenda.pdf (Accessed on October 17, 2011).
7. DeMillo A. “Ark. Insurance Officials Look at Health Exchange.” Forbes. October 11, 2011.
8. Level One Establishment grant funding proposal.
http://hbe.arkansas.gov/GrantApp12_22_11.pdf
9. Request for Proposals. Quality Health Plan Specialist. Arkansas Insurance Department. January 30, 2012.
http://hbe.arkansas.gov/RFQ_ID‐12‐0001.pdf
10. Request for Proposals. Navigator Program Consultant. Arkansas Insurance Department. February 13, 2012.
http://www.hbe.arkansas.gov/ID-12-0002.pdf
11. Request for Proposals. Navigator Program System Provider. Arkansas Insurance Department. March 8, 2012.
http://www.hbe.arkansas.gov/SP-12-0194.pdf