the Affordable Care Act’s passage in Congress in 2010.55 The enactment of
this bill elevated Arkansas, together with Kentucky, as the only Southern
states to provide health insurance coverage to all legal residents near or
below the poverty line.
Despite the nationwide difficulties with the 2013 rollout of the health
care Marketplaces (then called Exchanges), the results of the Arkansas
program so far have been promising. More than 233,000 previously
uninsured Arkansans have been approved for enrollment in the “private
option” or in the expanded traditional Medicaid program,56 halving the
proportion of uninsured from 22.5% to 11.4% of the population.57 This is
the highest percentage increase in insurance coverage of any state.58 A
nationwide county-by-county survey of the proportionate increase in the
insured population and of the percentage remaining uninsured offers
dramatic testimony of the program’s success, relative to surrounding states
(see Figures 2 and 3).
55. Among the many excellent accounts of the political battles leading to the passage of
the Affordable Care Act, a particularly thorough and objective source is STAFF OF THE
WASHINGTON POST, LANDMARK: THE INSIDE STORY OF AMERICA’S NEW HEALTH-CARE LAW
AND WHAT IT MEANS FOR US ALL (PublicAffairs ed., 2010).
56. See Andy Davis, Medicaid Program Accepts 10,000 in December, January, ARK.
DEMOCRAT-GAZETTE, Feb. 19, 2015, at 4B (reporting coverage approvals totaling 233,518 as
of Jan. 31, 2015). Of these, 195,520 were enrolled in the “private option” and 23,516 in the
traditional Medicaid program, and 14, 482 had been determined eligible for coverage but had
not completed enrollment. Id.
Enrollments remained high despite a legislative prohibition on the state Insurance
Department’s previous funding of outreach and education activities to promote the state’s
Marketplace. 2014 Ark. Acts 257, § 16 (2014 fiscal session), available at http://
www.arkleg.state.ar.us/assembly/2013/2014F/Acts/Act257.pdf. See Christie Swanson,
Deadline Near for Insurance Signup, ARK. DEMOCRAT-GAZETTE, Feb. 8, 2015, at 1A, 5A
(quoting Seth Blomeley, Insurance Dept. spokesman).
57. Peter Urban, Arkansas Sees Largest Drop in Uninsured Rate, Nationally (Feb. 24,
2015), available at http://arkansasnews.com/news/arkansas/arkansas-sees-largest-drop-uninsured-rate-nationally (summarizing Gallup report).
58. See Witters, supra note 10 (referencing “10 States with Largest Reduction in
Percentage Uninsured, 2013 vs. Midyear 2014” chart).