State Coverage Initiative looks at options for expanding coverage

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.

The proposal is already guaranteed to be controversial. At a meeting in Oklahoma City to discuss the report, Senator Brian Crain, who chairs the influential  Senate Health appropriations committee, flatly announced he would oppose any proposal for a provider fee, and he is unlikely to be alone. However, other key Republicans have expressed greater openness to a dedicated fee to expand coverage. The provider fee aside, the report raises many unanswered questions, particularly regarding the development of “affordable benefit plans”. For OK Policy, the challenge of extending coverage to adults below the poverty level is one priority that deserves additional attention, as we urged in this issue brief.

The report is most certainly a work-in-progress and subsequent versions will aim to flesh out more details. In the meantime, Commissioner Holland, her staff, and the members of SCI deserve to be commended for this effort to bring all the stakeholders together behind a single process to move the ball forward to address this urgent problem.

Update: Commissioner Holland spells out her vision for the SCI process in this Tulsa World op-ed from March 28th.


Former Executive Director David Blatt joined OK Policy in 2008 and served as its Executive Director from 2010 to 2019. He previously served as Director of Public Policy for Community Action Project of Tulsa County and as a budget analyst for the Oklahoma State Senate. He has a Ph.D. in political science from Cornell University and a B.A. from the University of Alberta. David has been selected as Political Scientist of the Year by the Oklahoma Political Science Association, Local Social Justice Champion by the Dan Allen Center for Social Justice, and Public Citizen of the Year by the National Association of Social Workers.

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