Observers worried about the future of Insure Oklahoma

Though it' s been praised by President Donald Trump and modeled by other states, an 18- year- old public- private, state health insurance program — on which thousands of small employers in Oklahoma rely to provide health insurance to their lowincome workers for as little as $80 a month — may end if Oklahomans vote to expand Medicaid next month.

As lawmakers considered their own plan to expand Medicaid ahead of the vote, state officials indicated they might shut down the program entirely.

Observers in Oklahoma' s insurance industry learned of the possible expiration of Insure Oklahoma (IO) when The Oklahoma Health Care Authority a few weeks ago announced, in a blog, the proposed phase- out of the program.

OHCA released plans for participants on IO' s employer-sponsored insurance to transition by year-end to coverage offered through healthcare.gov and for individual participants to start the transition next month to Medicaid, when the expansion passed by the legislature was to have taken effect.

The agency on Tuesday removed notice of the phaseout, along with notice of a June 8 virtual meeting for public comment, after Gov. Kevin Stitt last week vetoed a bill that would fund a different legislative Medicaid expansion. Stitt said funding for the Legislature's program would fall horribly short in the wake of widespread unemployment caused by the COVID-19 pandemic.

But observers still fear Insure Oklahoma will be jeopardized if Oklahomans vote to expand Medicaid. The state question will appear on the June 30 ballot.

Their fears very well could be justified, according to an official statement by OHCA on Wednesday to The Oklahoma n' s question ,“Is Insure Oklahoma safe?”

“The Oklahoma Health Care Authority is currently working with state leaders and CMS (the Centers for Medicare and Medicaid Services) to evaluate the available options regarding SoonerCare 2.0,” said Jonathan Cannon, senior director of communications.

“In the meantime,” Cannon said, “OHCA has suspended

the phase out of the Insure Oklahoma program pending further guidance regarding available options.”

According to figures on OHCA's website, Insure Oklahoma provides health insurance to 3,643 companies, which cover 14,140 participants, including 5,315 workers and 8,825 dependents. The vast majority of employers—from a trailer manufacturer in Chick ash a to a nursing home in Stroud — have 25 or fewer employers.

Another 7,662 Oklahomans are covered under IO's individual plans.

Insure Oklahoma, which is funded with state tobacco tax revenues matched with federal funds and has a capacity of 35,000, pays 60% of premiums f or workers. Employers generally pay 15% and employers, 25% — though some employers also cover their employees' cost.

In a recent letter to Stitt, the Oklahoma State Association of Health Underwriters implored him not to terminate the employer-sponsored insurance portion of I O whose participants “can not afford to pay health insurance premiums without the premium subsidy assistance of this program.”

Legislative chair Connie Morgan Kitchen said “this isn' t about being pro or anti Medicaid exp ansi on .” But, if Medicaid is expanded and Insure Oklahoma is disbanded, that will leave some 9,000 working Oklahomans who are covered under the program without insurance, because their earnings exceed the expanded poverty level limit of 133%, she said.

At 133% to 200% of the poverty level—or, $28,992 to $59,496 in annual incomes for households of one to four—those worki ng Oklahomans won't qualify for premium tax credits for healthcare. gov insurance plans, since they work for companies that offer insurance, she said. Without subsidies, they also won't be able to afford their employersponsored insurance, which would cost some $400 a month vs $80, she said.

Wayne Pet ti grew, senior consultant with Vanguard Benefits Group and a former legislator who helped create Insure Oklahoma, believes many employers won't be able to offer insurance if the employer-sponsored insurance portion of I O is discontinued. Many carriers require 50% employee participation even to offer plans, he said.

“If IO is phased out, it will be an embarrassment to Oklahoma,” Pettigrew said. “President Trump and others have praised the public-private program for offering a hand up vs. hand out for Oklahomans to buy health insurance and many states, including Arkansas, have modeled programs after ours.”

The I O programs ar e far more affordable than the federal marketplace plans, or t hose offered on healthcare. gov, said Larry Gundlach, owner of Oklahoma Business Insurors. Plus, IO offers some 37 plans versus eight on the marketplace, he said.

“Folks income-qualify to get Insure Oklahoma,” he said, “and don't want a stripped-down plan with large deductibles.”

Amber England, campaign manager for State Question 802, stressed that the proposed law doesn't directly affect Insure Oklahoma, but rather it would be OHCA's decision on whether to continue the program.