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Arkansas's Department of Insurance was awarded the $1 million HHS Exchange Planning grant in September 2010. Arkansas's planned activities for a planning process "guided by principles of consumer protection, stakeholder inclusion, integrated systems, quality, and cost-efficiency" include:

Creating an interagency executive planning team;

Securing assistance with research and analyses that will allow Arkansas to make informed planning decisions;and

Creating a final report which will include recommendations about: (1) Governance and administrator of the Arkansas Exchange; (2) Policy/regulatory needs including benefit standards, incentives, reporting, and monitoring requirements; (3) Existing technology and infrastructure to support Exchange operations; (4) Methods and costs for integrating Exchange eligibility and enrollment processes with those for Medicaid and other emerging health reform initiatives; (5) A start-up business/operations plan and five year sustainability plan for Arkansas’s Exchange.

In December 2010, Insurance Commissioner Jay Bradford, appointed Cynthia Crone as the Health Insurance Exchange Planning Manager.

In March 2011, Arkansas issued an RFP seeking to identify a qualified and experienced firm that will enter into a contract with the Arkansas Insurance Department to conduct background research, analyze data, identify options, and recommend a viable plan for developing and sustaining the Arkansas Health Benefits Exchange.

In March 2011, a bill was introduced in both the Senate (SB 904) and the House (HB 2138) to establish an Arkansas Health Benefit Exchange. HB 2138 would establish the Arkansas Health Benefit Exchange as " a political subdivision, instrumentality, and body politic of the State of Arkansas, and as such, not a state agency" overseen by a Board of Directors of seven members appointed by the Commissioner of Insurance. Neither bill was enacted before the end of the legislative session.

The State intended to apply for a Level One Establishment Grant by the September 30, 2011 deadline, but did not submit the grant following lack of Republican support in the State Legislature.

On December 2, 2011, Arkansas Insurance Commissioner Jay Bradford announced that planning efforts for the Arkansas Health Benefit Exchange had ended. In an official press statement released by the Insurance Department, Bradford explained that the decision was made following recommendations from the Health Benefits Exchange Planning Steering Committee: “This committee and the work groups have been a committed and wise group of individuals that are clearly driven by what is best for Arkansans. Although disappointed with this outcome, I have accepted the committee’s recommendation."

On February 22, 2012, Arkansas was one of ten states to receive an Exchange Establishment grant in the fourth round of grant awards. The Arkansas Insurance Department will use the Level One $7,665,483 award to design and implement key components of the Federally-facilitated Exchange Partnership Model and also accomplish the following:

Design and implement automation to connect Arkansas Medicaid and appropriate State-run Exchange functions with the Federally-facilitated Exchange Eligibility and Enrollment portal;

Design, develop, and implement operations and information systems to support State-operated Federally-facilitated Exchange Consumer Assistance functions including outreach, education, and the Navigator Program; and

Design, develop, and automate State-operated Plan Management functions of the Federally-facilitated Exchange including Qualified Health Plan certification, rating, monitoring, and evaluation to effect continuous quality improvement.

These activities will continue to be done in collaboration with state partners and informed by input from stakeholders. Arkansas also plans to design a temporary reinsurance program. Legislative approval for use of the funds was granted in April 2011 to the Department of Insurance following initial resistance from Republican lawmakers in the State.

Arkansas was among the six states to receive a Level One Establishment Grant. On September 27, 2012 CMS awarded the Arkansas Insurance Department with $18,595,072 to do the following:

Implement the Arkansas Qualified Health Plan (QHP) Certification Process and upload QHPs to the Federally Facilitated Exchange (FFE) portal in time for October 1, 2013 open enrollment;

Implement the Arkansas In‐Person Assister program to complement the federal Navigator Program and launch a workforce prepared to facilitate enrollment in the FFE;

Implement a targeted outreach and education program encouraging FFE enrollment; and

Study options and select the best method for promoting continuity of coverage and health provider networks among the large percentage of Arkansas residents expected to move between insurance affordability programs.

On January 3, 2013 Arkansas received conditional approval from the Centers for Medicare and Medicaid Services to establish a State Partnership Exchange.