The Data Is In: Oklahomans are actively using Affordable Care Act

Photo by Christiana Care / CC BY-NC-SA 2.0
Photo by Christiana Care / CC BY-NC-SA 2.0

Steven Goldman, PhD is a Navigator at Oklahoma Primary Care Association. He can be reached at

Although the Affordable Care Act (ACA) recently reached its fifth year, the law’s main incentives for expanding health coverage are still young. The health care law’s second Open Enrollment Period just concluded in February 2015. Now the the enrollment data from the US Department of Health and Human Services is in, and it makes two important points: that Oklahomans are interested and engaged in purchasing health insurance on, and that those purchases are having a strong impact on the state economy.

In Oklahoma, 126,115 individuals enrolled in ACA Marketplace health plans for 2015 – an 80 percent increase over the 69,221 enrollees for 2014. The majority (54 percent) were new to the Marketplace, demonstrating growing interest in among Oklahomans. For most Oklahomans purchasing insurance on, premium tax credits played a significant role in making that insurance affordable. Seventy-nine percent of enrollees (100,039 Oklahomans) received tax credits based on income and other qualifying factors. On average, the tax credit reduced the monthly premium paid by consumers from $295 to $89 – a 70 percent reduction.

Plans chosen to meet needs, not just by price

Oklahomans were choosy in buying coverage rather than simply selecting the plan with the lowest premium or staying with the same plan they chose the previous year. Of those who used premium tax credits, 4 in 5 could have selected a plan with a monthly premium of $50 or less, but only 2 in 5 did. Similarly, while 93 percent could have selected a plan with a monthly premium of $100 or less, only two-thirds did. This suggests that when Oklahomans bought insurance, they focused less on minimizing costs and more on maximizing the quality of the insurance purchased.

Furthermore, Oklahomans who had purchased insurance on the exchange last year shopped around. Among those who actively re-enrolled by reviewing all available plans for 2015, over half switched to a different plan than they had in 2014. This “Active Re-enrollment” was encouraged during Open Enrollment, since the Marketplace allows consumers to go shopping each year for a health plan that best meets their needs, and to update their family and income information so they are eligible for the proper amount of tax credits.

Marketplace attractive to Oklahomans, even without tax credits

graph 1Oklahoma continued to have a high rate of people enrolling through the Marketplace even though they did not qualify for financial assistance (e.g. tax credits or cost-sharing assistance). Almost 1 in 5 of the Oklahoma enrollees who used the Marketplace were not eligible for tax credits (tax credits are only eligible for those earning up to 400 percent of the federal poverty level – about $63,000 per year for a two-person household). While there may be many reasons for using the Marketplace, these consumers were likely relatively affluent, with income above the tax credit range, yet found the shopping, comparison and enrollment system convenient. Oklahoma is among the top five states for Marketplace enrollment proportion without financial assistance on

Tax credits aid Oklahomans, insurers and health care workers

[pullquote]”The data shows that Oklahomans are not merely tolerating the law but actively engaging with it.”[/pullquote]For nearly all policy holders, their tax credits go directly to the health insurance companies. With 100,039 Oklahoman enrollees qualifying for an average monthly tax credit of $206, this works out to $20,600,000 per month in savings for Oklahomans – $247.3 million per year – deposited directly in Oklahoma-based insurance companies. This money then flows to Oklahoma’s health care workers and health care businesses.

While the ACA may remain contentious in some political spheres, this data shows that Oklahomans are not merely tolerating the law but actively engaging with it. With savvy shopping and careful spending, Oklahomans are pushing funds into the state economy and building a stronger, healthier future for themselves and their families.

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