The federal government is poised to let the state operate its Insure Oklahoma program for another year while it considers expanding Medicaid and taking a greater amount of federal money to insure low-income residents, a federal official confirmed on Friday.
A U.S. Centers for Medicare & Medicaid Services official with knowledge of the arrangement said the waiver for Insure Oklahoma would be for one year. The official spoke on condition of anonymity because an official announcement had not been made.
Oklahoma Gov. Mary Fallin had sought ways to rescue the Insure Oklahoma program, which provides individual and employer-sponsored health insurance plans to about 30,000 low-income residents. She planned to make an official announcement with federal and state officials late Friday morning at the state Capitol.
Amid bitter resistance from some Republicans, Fallin rejected both the Medicaid expansion and the opportunity to set up a state-based insurance exchange where Oklahomans could purchase health insurance with federal tax subsidies. Both were offered under the Affordable Care Act, also known as Obamacare. Instead, Oklahoma residents who earn up to 400 percent of the federal poverty level, or $94,200 for a family of four, will be able to buy policies online through a federal exchange beginning Oct. 1.
But some state residents, including thousands on the Insure Oklahoma program, would have fallen into a "coverage crater" where they would have been ineligible for tax subsidies or Medicaid. Federal officials planned to terminate the Insure Oklahoma program because most of its recipients would have otherwise been eligible for the Medicaid expansion if they earned up to 138 percent of federal poverty, or $32,499 for a family of four.
Republican legislators favor Insure Oklahoma program over Medicaid expansion because individual recipients pay modest co-pays, with the rest of the premiums covered by employer payments in some cases, along with state and federal matching funds.
The state's portion of the funding comes from a tobacco tax approved by voters and is used to draw down matching federal Medicaid dollars.
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