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Oklahoma health insurance exchange

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Oklahoma health insurance exchange

By
healthinsurance.org contributor
July 24, 2014

69,221 people in Oklahoma had finalized their private plan enrollment in the state’s exchange by April 19 – more than double the number who had done so by March 1. The vast majority (about 60,000) of the private plans were sold by Blue Cross Blue Shield of Oklahoma, and the carrier reported that another 25,000 people purchased their ACA-compliant plans off-exchange.  Obamacare enrollment has continued since April, due to qualifying events that trigger special enrollment periods; HHS will release total enrollment numbers again in November, which is also when the 2015 general open enrollment period is scheduled to begin.

By mid-April, 17,374 applicants were eligible for Medicaid or CHIP under existing rules (they were already eligible pre-2014, but not enrolled).  Oklahoma is not participating in Medicaid expansion at this time.  Instead, in early September 2013, the state negotiated with the federal government to get a one year extension for the Insure Oklahoma program.   The state received a second extension in June, 2014 that will keep Insure Oklahoma functional throughout 2015.  The program subsidizes private health insurance for low income residents (up to 200% of poverty level), using tobacco taxes matched with federal funds that were scheduled to expire at the end of 2013 to make way for Medicaid expansion.  The program will now continue to receive federal funds through 2015, but it now covers about 19,000 of the 30,000 original enrollees, since Insure Oklahoma members with incomes above 100% of poverty have been able to transition to the federally-run Oklahoma exchange instead (roughly 225,000 residents in Oklahoma would have benefited from the expansion of Medicaid).

Despite the fact that Oklahoma has not expanded Medicaid, the state’s program is facing a budget shortfall and in early July announced a 7.75 percent cut in Medicaid reimbursement rates for providers, which will result in a $48 million savings for the state, but leaves providers facing reduced payments, even as they provide healthcare for more than 17,000 new enrollees in the state’s Medicaid program.

Gov. Mary Fallin announced in November 2012 that Oklahoma would not implement a state-run health insurance exchange. In the same press release, Fallin expressed her support for a lawsuit brought by Oklahoma Attorney General Scott Pruitt. The suit contends the federal government cannot enforce the employer mandate or dispense tax subsidies in a state that has not authorized an exchange.  On August 12, 2013, a federal judge denied the federal government’s motion to dismiss the case, and it is currently pending in federal court (however, on January 15, a federal judge ruled against a group of private plaintiffs who were making a similar case in Halbig v. Sebelius.  That case is currently being appealed).

In addition to the lawsuit, on November 6 Pruitt joined AGs from nine other states in petitioning HHS Secretary Kathleen Sebelius to support “immediate legislative action” to correct various aspects of the ACA’s implementation.  And in February 2014, Republican Rep. Jon Echols introduced HB3364, which would provide a state tax credit to offset any shared responsibility penalties (individual mandate) incurred by Oklahoma residents.  The bill did not proceed any further than introduction however.

Not surprisingly, a study released in late January found that Oklahoma was one of just five states that were “diehard hold outs” with regards to the ACA – doing nothing at all to help implement the law.

Oklahoma was already allowing insurers to renew existing pre-ACA policies into 2014 prior to President Obama’s announcement in mid-November that states and carriers could renew – rather than terminate – plans that were not ACA compliant for another year.  So the state has largely avoided widespread cancellations in the individual and small business markets.

The Fallin administration state officials initially showed some openness to a state-run exchange — if only as a slightly less distasteful option than a federally operated exchange. The Oklahoma Joint Committee on Federal Health Care Law studied exchange options and issued its final recommendations in February 2012. The committee supported a state-run exchange open to small businesses, but not individuals. A bill for this type of exchange, which is similar to Utah’s exchange, was introduced but not passed in 2012.

In line with state leaders’ opposition to the ACA, Oklahoma is not actively marketing the exchange to residents.  However, three state organizations have received grants to act as navigators: Cardon Outreach in Oklahoma City, Oklahoma Community Health Centers, Inc., and Little Dixie Community Action Agency, Inc.  Five carriers are offering a total of 53 health plans in the Oklahoma exchange.

According to Kaiser’s statehealthfacts.org, about 17 percent of people in Oklahoma do not have health insurance.

HHS is running the exchange in Oklahoma.  You can compare plan, determine subsidy eligibility and enroll in coverage at Healthcare.gov.

Oklahoma health insurance exchange links

HealthCare.gov
800-318-2596

State Exchange Profile: Oklahoma
The Henry J. Kaiser Family Foundation overview of Oklahoma’s progress toward creating a state health insurance exchange.

Oklahoma Insurance Department
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care. (405) 521-2991  / Toll Free in OK: (800) 522-0071 / ombudsman@oid.ok.gov

Voice your concerns to your
Oklahoma elected officials

tell your elected officials

Let your Oklahoma governor and legislators know how you feel about the state’s proposed health insurance exchange.

Oklahoma Governor Mary Fallin
2300 N. Lincoln Blvd., Room 212
Oklahoma City, OK 73105 Oklahoma City, OK 73105
PHONE: (405) 521-2342
FAX: (405) 521-3353
Contact by e-mail
Contact your Oklahoma State Senator and State Representative

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