Health insurance in Oklahoma
- Oklahoma uses the federally facilitated health insurance exchange.
- Open enrollment in Oklahoma for 2021 health plans ended on December 15, 2020. Outside that window, residents need qualifying events in order to enroll.
- Six insurance companies offering health plans in the exchange for 2021, up from three in 2020.
- Short-term health insurance plans can be sold in Oklahoma with initial plan terms up to 364 days.
- Nearly 159,000 Oklahomans purchased health insurance plans for 2020 coverage.
- Oklahoma lawmakers have been mostly opposed to the Affordable Care Act, but have also tried to craft state-based health care reform.
- Oklahoma voters approved Medicaid expansion in June 2020; coverage expected to take effect by mid-2021.
- Oklahoma’s high-risk pool ceased operations in 2014, after the ACA made individual-market coverage guaranteed-issue.
- More than 746,000 Oklahomans are enrolled in Medicare – including private Medicare plans.
This page offers information and guidance for consumers seeking health insurance resources in Oklahoma. We’ve included an overview of the Oklahoma health insurance marketplace (exchange) and the upcoming open enrollment period for individual market health insurance; details about the ballot initiative that will result in Medicaid expansion in Oklahoma by mid-2021; a quick look at short-term health insurance rules and availability in the state; information about state-specific Medicare rules and Medicare enrollment; as well as various other health insurance resources for Oklahoma residents.
Oklahoma’s health insurance marketplace
Oklahoma has a federally facilitated exchange (marketplace), which means individuals and families use the HealthCare.gov website to shop for health insurance.
For 2021, six health insurance companies will offer health plans through the Oklahoma exchange, including three newcomers: Oscar, UnitedHealthcare, and CommunityCare Oklahoma. They will join the three existing exchange insurers (Bright Health, Blue Cross Blue Shield of Oklahoma, and Medica).
BCBSOK and Medica have service areas that include the entire state, while the other four have more limited service areas. So plan availability varies from one part of the state to another.
The marketplace is used by individuals and families who need to purchase their own health insurance. This includes people who have retired prior to age 65 (and thus aren’t yet eligible for Medicare), people who are self-employed, and people who are employed by a small business that doesn’t provide health benefits to employees (under the ACA, only businesses that have 50 or more workers are required to offer employer-sponsored health coverage).
The marketplace is also the only place where individual market enrollees can get financial assistance with their health insurance, depending on their household income. This includes premium subsidies that reduce the monthly premiums people pay for their coverage, and cost-sharing reductions that make out-of-pocket medical expenses (deductible, copays, coinsurance) less costly.
See our detailed overview of Oklahoma’s exchange, including history, news, enrollment numbers, and plan availability.
Oklahoma open enrollment period and dates
Open enrollment for 2021 health plans in Oklahoma ran from November 1 through December 15, 2020. The open enrollment period gives individuals and families a chance to sign up for coverage, regardless of prior coverage history or pre-existing conditions. It’s also an opportunity for existing individual market enrollees — both on-exchange and off-exchange — to compare the available options for 2021 and either renew their current insurance coverage or change to a different plan. The entry of three new insurers to Oklahoma’s marketplace for 2021 makes it especially important for people to actively shop and compare the various plans, as there may be a new option available in their area that provides a better value than the plan they currently have.
Outside of the open enrollment period, applying for an individual market plan (on-exchange or off-exchange) requires proof of a qualifying event.
During the open enrollment period for 2020 health coverage, 158,642 people purchased private individual-market plans through the Oklahoma health insurance marketplace. Only a handful of states that use HealthCare.gov saw enrollment growth in 2020. Oklahoma is among them; only four states had a larger percentage increase in enrollment from 2019 to 2020.
Read our guide to the Oklahoma health insurance marketplace.
Short-term health insurance in Oklahoma
Prior to November 2019, Oklahoma had fairly strict regulations for short-term health insurance plans – the policies couldn’t last more than six months, and couldn’t be renewed. But the state enacted legislation in 2019 that changed those rules.
As of November 2019, short-term health insurance coverage in Oklahoma can follow the federal rules that allow for initial terms of up to 364 days, and total duration, including renewals, of up to three years.
Read more about short-term health insurance in Oklahoma.
Medicaid expansion in Oklahoma
As of May 2020, there were 773,600 Oklahoma residents enrolled in Medicaid (SoonerCare) and CHIP in Oklahoma. That’s a decrease of 2 percent since 2013, although it’s an increase of about 50,000 people since the start of 2020. The coronoavirus pandemic has been driving Medicaid enrollment higher throughout the country, even in states where Medicaid has not yet been expanded under the ACA’s rules.
Oklahoma voters passed a Medicaid expansion ballot initiative that will allow eligibility expansion to take effect in July 2021. Meanwhile, Oklahoma is still pursuing a waiver that would allow for a Medicaid work requirement. Work requirements are not currently in effect anywhere in the country, although federal approval has been granted for several other states. Some have been overturned by judges, while others have been paused or suspended amid legal battles and the COVID pandemic.
Read our full overview of Medicaid expansion in Oklahoma.
Oklahoma and the Affordable Care Act
Oklahoma is one of five states initially considered “diehard hold outs” against Obamacare, according to a 2014 study from Georgetown University. In 2010, both of Oklahoma’s U.S. Senators, Republicans Thomas Coburn and James Inhofe, voted no on the ACA. In the U.S. House, one Democrat, the second district’s Dan Boren, voted yes, while four Republican Representatives from Oklahoma voted no. As of 2018, the entire U.S. congressional delegation from Oklahoma was Republican, but Kendra Horn, a Democrat, has been representing the 5th District in the House since January 2019.
At the state level, there’s a strong Republican majority in both the House and Senate, and Gov. Kevin Stitt is also a Republican. Stitt opposes Medicaid expansion (although he had proposed SoonerCare 2.0, which called for expansion with subsequent restrictions added to the program, but withdrew his support for it amid the coronavirus pandemic and the resulting increase in the number of people who would need expanded Medicaid) and believes that selling health insurance across state lines is a key to reducing premiums (Oklahoma enacted legislation in 2017 to allow this, but like the handful of other states that have done the same thing, they’ve had no interest from insurers wanting to participate).
But Oklahoma has also worked to try to create state-based healthcare reform solutions within the framework of the ACA. In 2017, Oklahoma submitted a 1332 waiver proposal to CMS, seeking federal pass-through funding for a reinsurance program (and the state was planning extensive additional reform via additional 1332 waivers that were to be submitted subsequently). But Oklahoma ultimately withdrew the waiver proposal amid delays in the federal approval process, when it was clear that the approval wouldn’t happen in time for rates to decrease for 2018.
Oklahoma enacted another bill, in 2018, authorizing the state to seek federal funding for a reinsurance program, but the state did not submit a waiver proposal to the federal government, so there is still no reinsurance program in Oklahoma.
Does Oklahoma have a high-risk pool?
Prior to 2014, individual medical insurance was underwritten in nearly every state, including Oklahoma. This meant that pre-existing conditions could prevent an applicant from getting coverage, or could result in significantly higher monthly premiums or policy exclusions.
The Oklahoma Health Insurance High Risk Pool (administered by Blue Cross Blue Shield of Oklahoma) was created in 1995 to provide an alternative for people who were ineligible to purchase individual medical insurance because of their medical history.
Implementation of the ACA and a guaranteed-issue individual market have eliminated the need for high-risk pools, and the Oklahoma Health Insurance High Risk Pool ended operations as of December 31, 2014.
Medicare coverage and enrollment in Oklahoma
Medicare is a health coverage program provided by the federal government for elderly and disabled Americans. As of August 2020, there were 751,324 Oklahoma residents enrolled in Medicare. About a quarter of Oklahoma beneficiaries are enrolled in Medicare Advantage plans, while the rest have Original Medicare.
In most cases, receiving a Medicare card goes along with turning 65. But 18 percent of the people with Medicare in Oklahoma are under the age of 65 and are eligible for Medicare because of a long-term disability, ALS, or end-stage renal disease.
You can read more about Medicare in Oklahoma, including statistics about state Medicare spending, details about Medicare Advantage and Medicare Part D prescription drug coverage, and Oklahoma’s rules for Medigap (Medicare Supplement) plans.
Oklahoma health insurance resources
- Oklahoma Insurance Department — Regulates and licenses health insurance companies, brokers, and agents, and can address consumers’ questions and complaints. But Oklahoma is one of just three states where the insurance department does not conduct the premium rate review process (the federal government handles it instead).
- Legal Aid Services of Oklahoma — The federally-funded Navigator organization in Oklahoma; can help residents understand their health insurance options and enroll in coverage through HealthCare.gov.
- Oklahoma Medicare Assistance Program — Help for Medicare beneficiaries and their caregivers; includes the Senior Health Insurance Counseling Program and Senior Medicare Patrol.
- Medicare Rights Center — A nationwide service that provides information and answers questions about Medicare
Oklahoma healthcare reform legislation
Scroll to the bottom of this page for a summary of recent Oklahoma bills related to public health and healthcare reform.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.