Establishing the Exchange
In 2011, Oklahoma established the Joint Committee on Federal Health Care Law to explore the state’s options regarding federal health reform, including exchange implementation in the state.1,2 Exchange legislation failed in 2011 before the legislature adjourned.
The Joint Committee convened regularly between September and November 2011, and released final exchange recommendations to the Governor and the Legislature in late February 2012.3,4 Committee recommendations included establishing a state-based private marketplace network to avoid federal involvement in the state; this would resemble a Utah model for small-businesses but would not include an individual exchange. A bill based on these recommendations was introduced in the 2012 legislative session (SB 1629).5 However, this legislation does not comply with provisions in the Affordable Care Act.
The Oklahoma Health Insurance Exchange Project, led by the Secretary of Health as liaison to the Governor’s Office and State Legislature, the Oklahoma Department of Mental Health and Substance Abuse Services, the Insurance Department, and the Oklahoma Health Care Authority, began planning efforts in early 2011. The Exchange Project’s six work groups met monthly until the summer of 2011, focusing on information technology; education and marketing; financial management and premium development; enrollment, eligibility process and infrastructure; carrier and plan selection; and governance administration. The Exchange Project which planned to compile stakeholder feedback through a series of working group meetings and perform an information technology gap analysis, suspended activities in 2012 due to the exhaustion of grant funds.
On April 4, 2011, Governor Mary Fallin (R) signed into law a measure prohibiting any health insurance plans offered in the exchange from covering abortions except in cases of rape, incest, or life endangerment of the pregnant woman (SB 547).6 The bill allows health plan enrollees the option to purchase additional abortion coverage if desired.
Exchange Funding
Oklahoma’s Department of Mental Health and Substance Abuse Services received a $1 million federal Exchange Planning grant. In addition, the Oklahoma Health Care Authority received a $54.5 million Early Innovator grant to develop model technological infrastructure for a health insurance exchange.7 In April 2011, Governor Fallin announced that Oklahoma planned to return the Early Innovator grant funding.8
Next Steps
In March 2012, the Oklahoma state Legislature announced the state will wait until after the Supreme Court rules on the constitutionality of the health care law before proceeding with SB 1629.9,10 With the state’s legislative session ending in late May and a Court ruling not expected until June, there is an increased likelihood the state will not meet the federal timetable for implementation. Oklahoma has until January 1, 2013, to create a state-based exchange that the U.S. Department of Health and Human Services approves as fully or conditionally operational. If not approved, the federal government will assume responsibility for running a health insurance exchange in the state.
For more information on Oklahoma’s health insurance exchange planning, visit: http://www.okhealthcare.info/
1. Press release. Health Care Law to be Studied over Interim. May 18, 2011. http://www.okhouse.gov/OkhouseMedia/ShowStory.aspx?MediaNewsID=4000
2. Joint Committee of Federal Health Care Law. Committee Formation. http://garystanislawski.net/okhealthcare.info/Committee%20Formation.pdf
3. Summary of the Meetings of the Joint Committee on Federal Health Care Law. September 14, 2011- November 3, 2011. http://garystanislawski.net/okhealthcare.info/Presentations/Joint%20Comm%20Fed%20Health%20Care%20Laws%20summ.pdf
4. Final Report of the Joint Committee of Federal Health Care Law. Oklahoma Legislature. February 22, 2012. http://www.tulsaworld.com/webextra/content/items/FINAL%20Joint%20Committee%20on%20Federal%20Health%20Care%20Law%20Report.pdf
5. SB 1629. 2012 Regular Session. http://www.ok.gov/redirect.php?link_id=332
6. Senate Bill 547. Approved by Governor April 20, 2011. http://www.oklegislature.gov/BillInfo.aspx?Bill=sb547
7. Early Innovator Grant Awards. HHS announcement. February 16, 2011. http://www.healthcare.gov/news/factsheets/exchanges02162011a.html (Accessed August 23, 2011)
8. Politico. 'Oklahoma governor returns $54M health care grant.' April 14, 2011. http://www.politico.com/news/stories/0411/53216.html
9. Oklahoma State Legislature. SB 1629 on hold pending Supreme Court action. For immediate release March 8, 2012. http://www.oksenate.gov/news/press_releases/press_releases_2012/pr20120308c.html
10. Greene, Wayne. ‘Oklahoma’s response to Obamacare recommends partial step toward health exchange.’ February 23, 2012. Tulsa World. http://www.tulsaworld.com/news/article.aspx?subjectid=11&articleid=20120223_16_A1_OKLAHO387921