Frequently asked questions about health insurance coverage options in Oklahoma
Oklahoma has a federally facilitated exchange (marketplace), which means individuals and families use the HealthCare.gov website to shop for health insurance.
189,444 people enrolled in private individual market plans through Oklahoma’s exchange during the open enrollment period for 2022 coverage. This was by far a record high for the state, driven largely by the American Rescue Plan‘s subsidy enhancements, which have been extended through 2025 by the Inflation Reduction Act.
The open enrollment period for individual/family health coverage runs from November 1 to January 15 in Oklahoma. Outside of open enrollment, a qualifying event is necessary to enroll or make changes to your coverage.
Learn more about enrollment opportunities in our comprehensive guides:
In Oklahoma, consumers may be able to buy affordable individual and family health insurance by enrolling through the ACA marketplace (HealthCare.gov). More than 90% of consumers who enrolled in 2022 coverage through HealthCare.gov received premium subsidies.
Oklahomans may also find affordable coverage through Medicaid if they’re eligible. See Medicaid eligibility guidelines in Oklahoma.
Short-term health insurance is also a lower-cost coverage option in Oklahoma, where seven insurers offer short-term plans.
For 2022, there are eight insurers offering plans in the Oklahoma exchange, including two insurers that joined as of 2022 (Friday Health Plans and Centene/Celtic, which is branded as Ambetter in Oklahoma).
But Bright Health is leaving the Oklahoma market at the end of 2022, so there will be seven insurers offering plans for 2023, with varying coverage areas:
- Blue Cross Blue Shield of Oklahoma
- Oscar
- Medica
- CommunityCare
- UnitedHealthcare
- Friday Health Plans
- Ambetter (Centene/Celtic)
Insurer participation in Oklahoma’s exchange has grown steadily over the last few years, from one insurer in 2017 and 2018 to eight in 2022. In addition to the two new insurers for 2022, Oklahoma gained three new exchange insurers as of 2021 (Oscar, UnitedHealthcare, and CommunityCare HMO; CommunityCare already offered coverage in Oklahoma outside the exchange; their plans became available in the exchange for 2021).
But insurer participation will decline in 2023, for the first time in several years, with Bright Health’s exit from the Oklahoma market.
For 2023 coverage, Oklahoma’s exchange insurers have proposed an overall semi-weighted average increase of about 8.8% (note that one of the eight existing insurers, Bright Health, is not returning for 2023 so Bright’s enrollees will need to switch to other insurers’ plans for 2023).
During the open enrollment period for 2022 coverage, a record-high 189,444 people enrolled in private individual market plans through Oklahoma’s exchange. The sharp increase in enrollment for 2022 was driven in large part by the American Rescue Plan‘s subsidy enhancements. And the Inflation Reduction Act has extended those subsidy enhancements through 2025.
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 2022, the entire U.S. congressional delegation from Oklahoma is Republican.
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 opposed 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; Medicaid was eventually expanded in Oklahoma due to a voter-approved ballot measure) 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.
As of May 2022, there were 1,203,318 Oklahoma residents enrolled in Medicaid (SoonerCare) and CHIP. That was a 52% increase from late 2013.
Most of that growth had occurred since mid-2021, when Oklahoma implemented Medicaid expansion under the terms of a ballot measure that voters in the state approved in 2020.
Read more about Medicaid expansion in Oklahoma.
In addition to Medicaid expansion, the COVID pandemic has driven Medicaid enrollment higher across the country. Under the terms of the Families First Coronavirus Response Act, states are receiving additional federal Medicaid funding, but also cannot disenroll anyone from Medicaid during the COVID public health emergency. Once the public health emergency ends, routine Medicaid eligibility redeterminations will resume.
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.
Since November 2019, short-term health insurance coverage in Oklahoma has been allowed to 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.
As of May 2022, there were 767,330 Oklahoma residents enrolled in Medicare. Nearly a third of Oklahoma beneficiaries are enrolled in Medicare Advantage plans, while the rest have Original Medicare (nationwide, about 46% of Medicare beneficiaries were enrolled in Medicare Advantage as of 2022).
In most cases, receiving a Medicare card goes along with turning 65. But almost 16% 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 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
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.
