The ‘Oklahoma Health Insurance Exchange’ will begin serving as an online marketplace for individual and small group consumers to buy private insurance in 2014.  Online insurance exchanges – which we discussed in this recent blog post -  are one of the primary requirements of the Affordable Care Act passed by Congress last year. News from the governor’s office that the state has accepted a $54 million dollar ‘early innovator’ grant from the federal government means that Oklahoma is now poised to build the most advanced insurance exchange in the country.

Why was Oklahoma one of only six states selected for this grant?  There are two programs that uniquely position Oklahoma as an innovator of health care information technology:  Insure Oklahoma (IO) and SoonerCare online enrollment (OE).  Online enrollment for SoonerCare, the state’s Medicaid program, went live in September 2010 and has already dramatically improved the efficiency of the application process.  Applicants input required information on family members, income, etc. into a web-based interface, and their eligibility is determined in real-time (subject to verification). Three months after online enrollment launched, only 7 percent of SoonerCare applications were paper.  OK Policy blogged about the launch of online enrollment and the resulting national accolades this past December. Read the rest of this entry »

This is the sixth in an ongoing series of posts examining the Affordable Care Act, including previous posts on the Temporary High Risk Pool and tax credits for small businesses.  You can also visit the health care reform page on our website for more resources and information.  If you have thoughts on health care reform, we encourage you to comment below or contribute a guest blog.

One of the most important provisions of the federal health care reform law, officially known as the Affordable Care Act (ACA), is the requirement that states establish private insurance marketplaces, or ‘Exchanges’, to sell plans to individuals and small groups in their state.  Health insurance exchanges were written into the law to ensure that these particularly vulnerable segments of the market – individuals and small groups – could obtain affordable coverage.  What is unique about these segments?  Well, consider how insurance works for a large group employer:  every employee is covered regardless of medical history and all employees pay roughly the same premiums.  This is possible, and perhaps more importantly profitable, because the risk of covering the sicker/costlier employees is offset by the ease of covering healthier/cheaper employees. Read the rest of this entry »

According to the latest U.S. Census figures, 565,000 Oklahomans, or 15.8 percent of the total population, were without health insurance in 2007-2008. The uninsured rate is just under 10 percent for children but over 20 percent for adults ages 18-64.

The Oklahoma Legislature has made several efforts in recent years to chip away at the number of uninsured by expanding eligibility for Insure Oklahoma, a program that provides public subsidies towards the purchase of employer-sponsored coverage for employees of small businesses or a public product for those without access to employer coverage. Eligibility for Insure Oklahoma goes up to 200 percent of the federal poverty level ($44,000 for a family of four) and is available to employees of businesses with up to 250 employees. Read the rest of this entry »

Burgerville, a small fast-food chain in the Pacific Northwest, has always made a killer fresh blackberry shake. Recently, it also made a shrewd business move: providing health insurance for employees. Last week, the Wall Street Journal reported on the genesis and results of this new strategy. Read the rest of this entry »

The News on 6 in Tulsa reported last week on Oklahomans who lack health insurance. OK Policy’s David Blatt was featured in the story, available here in both print and video, describing who is likely to be uninsured and explaining how care for the uninsured drives up premium costs for everybody. Read the rest of this entry »

Last week,  I attended a meeting of the State Coverage Initiative (SCI), an effort that has taken shape over the past two years under the leadership of Insurance Commissioner Kim Holland to develop a plan to extend health insurance coverage to a sizable segment of the 640,000 Oklahomans who are currently uninsured. The meeting reached a consensus on adoption of the SCI strategic plan, which lays out a blueprint for expanding coverage.

The cornerstone of the plan would be a gradual expansion of Insure Oklahoma, the public-private partnership which provides subsidized employer-based coverage for working adults, along with a public product for eligible adults without access to employer coverage. The program, which is funded by a portion of tobacco tax revenues approved by voters in 2004,  has now grown to cover just under 20,000 Oklahomans, which is about half of the capacity under existing revenues. The principal SCI recommendation is to generate new revenues by assessing a dedicated fee on all health insurance claims paid by health insurers in Oklahoma. It is estimated than an initial 1 percent fee would generate $78 million that, along with matching federal funds, could insure an additional 80,000 Oklahomans.  If and when 75 percent of the target population is reached, the assessment would increase.

The main argument advanced by the SCI leadership in favor of the new health care assessment is the need to confront the enormous cost-shifting that currently takes place in paying for health care for the uninsured. As Commissioner Holland stated in a recent op-ed:

One billion dollars each and every year. That’s how much it costs to provide health care to the citizens of Oklahoma who do not or cannot pay for the care they need and receive. That’s $1 billion that is added to the medical bills and insurance premiums of those who do pay. Imagine what would happen if this $1 billion hidden tax were eliminated — health care costs would be reduced, and health insurance premiums would be reduced.

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Over the past two years,  Insurance Commissioner Kim Holland has been spearheading an extensive effort known as the State Coverage Initiative (SCI) to develop a plan to extend health insurance coverage to a sizable segment of the 640,000 Oklahomans who are currently uninsured. SCI has recently released a blueprint report setting out its main recommendations.

The SCI report calls on the state to maximize existing opportunities for covering the uninsured through the Insure Oklahoma premium assistance program and to create new publicly-subsidized commercial health plans, which would attempt to control costs either by capping annual benefit limits or by waiving current state mandate requirements. The report proposes funding expanded coverage through a broad-based provider fee that would begin at a modest 0.5 percent of revenues.
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