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Arkansas' uninsured fall below U.S. rate

7.9% of state without health care

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."

Based on surveys of more than 2 million people each year, the American Community Survey has collected information on health coverage since 2008.

Respondents are asked what type of coverage they have at the time of the survey. The margin of error in 2016 was plus or minus 0.4 percentage points for Arkansas' uninsured rate and 0.1 percent for the national rate.

Part of data from the 2016 survey was released Tuesday, and more detailed figures are scheduled to be released today.

Despite the coverage expansion, the percentage of Arkansans who were uninsured remained highest among those with incomes low enough to qualify for assistance.

Among Arkansans with incomes of less than 138 percent of the poverty level, the percentage of Arkansans who lacked insurance fell from about 16 percent to 12 percent, with more than 94,000 remaining uninsured.

That compared to 8 percent of Arkansas with incomes of 138 to 399 percent of the poverty level who were uninsured in 2016. Just 3 percent of Arkansans with incomes of at least 400 percent of the poverty level were uninsured.

The report also found that the percentage of Arkansas children who lack insurance fell from 4.9 percent in 2015 to 3.6 percent last year.

Nationally, the percentage of uninsured children fell from 4.8 percent to 4.5 percent.

Thompson said the percentage of Arkansans with insurance is likely to continue to grow as more people learn about their options.

He noted that, according to a center report, 78,640 Arkansans faced a financial penalty under the 2010 Patient Protection and Affordable Care Act for failure to maintain health coverage in 2014.

"Over time, everyone's going to have a health care need, and when people have needs is when they start thinking about, 'Do I need health insurance?'" Thompson said.

Metro on 09/14/2017

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