The Arkansas Department of Human Services sent out a press release (pdf) that is quite amazing. Arkansas is one of the few southern states not to outright reject the Medicaid expansion. They applied for and gained approval for an alternative to strict Medicaid expansion. Instead, they are taking the federal Medicaid money and using it to give people vouchers to buy a “private option” health care plan.

A total of 155,567 of the estimated 225,000 Arkansans who qualify for health insurance through the Private Option had applied and been determined eligible as of March 31, surpassing expectations of the level of acceptance in the program’s first year.

An analysis of demographic information of those in the Private Option showed that most – 82 percent– had incomes too low to qualify for insurance through the Health Insurance Marketplace.

“We now know that an overwhelming majority of Arkansans in the program would have likely gone without health insurance had the Legislature not passed the Private Option,” said John Selig, director of the Arkansas Department of Human Services. “Clearly there was a real need in a lot of these families.”

The Private Option, signed into law last April, allows the state to use federal Medicaid funding to pay the private health insurance premiums for those making up to 138 percent of the federal poverty level, or about $16,105 for a household of one. Arkansas was the first state in the country to place people in private plans rather than expand the traditional Medicaid program.

About 70% of eligible Arkansans took advantage of the subsidies. This is a category of person that is getting shafted in the rest of the Deep South and even here in Pennsylvania. They made too much to qualify for Medicaid under the old formula and too little to qualify for subsidies on the health exchanges. Caught in this donut hole, they aren’t receiving assistance in getting health insurance in much of the country. Yet, the Arkansas legislature found a solution they could live with, and we can see the result.

Over 155,000 people are getting coverage, which is almost as big as the margin former Sen. Blanche Lincoln lost by in the 2010 election. If you’re in the donut hole and living in Mississippi or Tennessee or Texas, you can look at Arkansas and wonder why your own legislators are putting you at needless risk of bankruptcy, or worse.

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