In addition to the low-income Arkansans who would gain health-insurance coverage through expansion of the state’s Medicaid program, more than 280,000 others will be eligible for subsidies for private insurance beginning Jan. 1, according to a report released Tuesday by a consumer advocacy group.
The report, commissioned by Washington, D.C.-based Families USA, estimated that 281,580 Arkansans, most of whom lack insurance, will be eligible for the subsidies through the insurance exchange being established under the federal Patient Protection and Affordable Care Act of 2010.
Of those, 252,250 people will be in families in which at least one member is working full or part time, the report says.
The numbers for Arkansas and other states were estimated for Families USA by The Lewin Group, a health-care research and consulting firm.
Nationally, the firm found that about 26 million uninsured people will be eligible for the subsidies, Families USA spokesman Robert Meissner said.
“For the overwhelming majority of people, this is going to be extraordinary help,” the group’s executive director, Ron Pollack, said.
The subsidies will be available to individuals and families who earn between 138 percent and 400 percent of the federal poverty level. Those thresholds, based on this year’s poverty guidelines, are $15,860 to $45,960 for an individual and $32,500 to $94,200 for a family of four.
The amount of the subsidy will depend on the family’s size and income and the premium for the second-lowest cost “silver” level, or medium-coverage, plan available where the family lives. For instance, an individual earning $45,960 would not have to pay more than 9.5 percent of his income - $4,366.20 annually - for the plan.
The tax-credit subsidy would pay for the remainder of the premium’s cost. The credits will be paid directly to the insurance companies at the time the premiums are due.
Those who would be eligible include 30,660 in Pulaski County, 23,490 in Washington County and 19,280 in Benton County, according to the report.
Those earning 138 percent of the federal poverty level or less will not be eligible for the tax credits, but they would be eligible to have their premiums paid by Medicaid under the expansion proposal pending in the Arkansas Legislature.
State officials have said the Medicaid expansion would extend coverage to an additional 250,000 people statewide who now lack insurance.
State officials have estimated that about 240,000 Arkansans who would not qualify for the expanded Medicaid program would be eligible for premium subsidies and predict that about 211,000 will enroll for coverage through the individual exchange or a small-business exchange in 2014, said Cindy Crone, planning director for Arkansas’ exchanges.
If enrollment is higher, that could mean lower premiums, she said.
“You have efficiencies of scale,” Crone said, because premiums paid by healthy people would offset the cost of providing care to others.
In addition to those who currently lack insurance, the Families USA estimate of those who will be eligible included insured people whose employers will stop offering coverage in 2014, as well as those who will be deemed eligible because their employer-sponsored coverage does not meet a federal affordability test.
The estimate also included legal immigrants who have been in the country for fewer than five years and have incomes below 100 percent of the poverty level. Those immigrants will be eligible for the tax-credit subsidies but not Medicaid, according to the report.
Kathleen Stoll, director of health policy for Families USA, said the organization does not have estimates for how many of those who currently have insurance or are immigrants would be eligible for the subsidies.
Front Section, Pages 7 on 04/17/2013