The future of more than 600,000 uninsured Oklahomans could be changing after the US Supreme Court ruled the Federal Health Care law constitutional.
Part of the law requires states to put together their own health care exchange or be forced to enroll in a federal program.
Many Oklahoma leaders have pointed to Insure Oklahoma, a plan the state already has in place for small businesses, as the means to create a statewide exchange, but no one has put forth any plan to show what it would look like or who would even manage it.
But, what is Insure Oklahoma?
About 40 employees for Insure Oklahoma sit in cubicles in what used to be one of the large department stores in the old Shepherd Mall in northwest Oklahoma City.
Insure Oklahoma pays 60% of premiums for employers and employees by pulling from the tobacco tax which was created by voters with the passage of State Question 713 in 2004.
Back then, qualifying businesses had to have less than 25 employees.
Adoption was pretty slow for the first few years, but Insure Oklahoma officials did massive advertising and grew fast enough to be able to include even more businesses.
Director Matt Lucas.
“As long as the business is located in Oklahoma, has 99 or fewer employees, is offering a qualified plan. The qualified health plans are commercial products that the carrier sells to anybody.”
Back then, the employees themselves could only qualify if they made 185% of the poverty level or less, but even that has grown to include people who make less than 200% of the poverty level.
Lucas says there’s also a safety net called the individual plan where Insure Oklahoma provides coverage.
“The employee at that point would make a premium payment directly to the state and then we issue an id card that then they could take and access services. We prefer the commercial route, but not everybody has access to insurance.”
So, now the agency works with nearly 5,000 businesses and more than 30,000 employees.
The businesses can also go online and select insurance products and submit simple forms to the Oklahoma Health Care Authority which manages the agency.
Spokesman Carter Kimble says Insure Oklahoma allows small businesses the opportunity to attract even more employees.
“When you think about it when you’re choosing between a small business that offers health insurance and one that doesn’t then obviously you gain that in the marketplace as an attractive employer.”
But that is without a universal health insurance requirement. So, how would it work when universal coverage is required by the Affordable Health Care Act?
The simple answer…no one really knows.
It was discussed last year in a Joint Committee on the Federal Health Care Law.
Co-Chair Senator Gary Stanislawski of Tulsa says under a plan put forth, an employer wouldn’t be mandated, but could opt-in to an exchange.
“The employer would contribute a defined contribution amount say $200 or $300 or $400 a month and put it into the account of that employee, and then the employee could go online and shop.”
According to the Affordable Care Act, states have to prove by January First of next year that they will be able to fully operate an exchange by the end of 2013.
But, the legislature ended the session without making any changes to Insure Oklahoma, and Governor Fallin, under pressure from fellow Republicans, rejected 54 million dollars to set up the exchange.
Any kind of exact plan for what the exchange would look like or how it would impact Insure Oklahoma has yet to be announced.
Governor Fallin says she wants to wait until after the general election in November before we get any specifics.
Without a direct plan, those 40 employees at Insure Oklahoma don’t really know what to tell employers who are trying to plan for the future.
Again, Matt Lucas…
“There’s just so much uncertainty right now I believe with the affordable care act and where we’re going that some businesses are just sitting on the sidelines waiting to see what happens.”
Lucas says when that happens more people go uninsured.
It’s a domino effect, the state waits on the federal government, employers wait on the state.
Senator Stanislawski says there are no plans to create another interim study or task force to discuss a health care exchange or the future of Insure Oklahoma.