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Insure Oklahoma deserves a five-year waiver, health leader says

Insure Oklahoma, operated through the Oklahoma Health Care Authority, provides insurance to employees of small businesses with 99 or fewer employees who meet certain income requirements.
by Jaclyn Cosgrove Modified: November 7, 2013 at 4:00 pm •  Published: November 6, 2013
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Nico Gomez isn't able to guarantee some of his staff that they'll have jobs past Dec. 31, 2014.

And he isn't able to guarantee hundreds of Oklahomans that they'll have insurance coverage past that date either.

It's the reality for the people employed or insured through Insure Oklahoma.

“There's stress on the people who are in the program going, ‘Do I enroll for another year? Do I not enroll for another year?'” said Gomez, the Oklahoma Health Care Authority CEO. “They're having to make decisions on something that, right now, all I can say is temporary.”

Insure Oklahoma, operated through the Oklahoma Health Care Authority, provides insurance to employees of small businesses with 99 or fewer employees who meet certain income requirements.

The program was set to expire at the end of 2013, but the federal government in September granted the program a one-year extension. But that extension didn't come without changes to the program.

Gomez answered questions about what changes Oklahomans can anticipate to the program in the coming year.

Why are the requirements changing?

When the federal government granted Insure Oklahoma an extension, it did so with modifications to the program.

The current Insure Oklahoma individual plan is available to people who earn up to 200 percent of the federal poverty level, but beginning Jan. 1 the program will only be available to workers who make up to 100 percent of the federal poverty level. The federal poverty level is $23,550 a year for a family of four.

On Jan. 1, Oklahomans who make between 100 percent and 200 percent of the poverty level will become ineligible for Insure Oklahoma participation. The Oklahoma Health Care Authority sent about 7,325 termination letters at the end of September.

Gomez said this change was part of the negotiation process between state and federal officials in determining Insure Oklahoma's future.

“We would have liked to have kept them, and we went back and forth about that, but that's how we ended up,” Gomez said. “At the end of the day, I was comfortable with (the changes) because they weren't going to lose a coverage opportunity. They have a coverage opportunity through the marketplace.”

Gomez said the decision was made before HealthCare.gov, the federal government's marketplace website, rolled out, and before it became clear that the website had several flaws that needed to be worked out.

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by Jaclyn Cosgrove
Medical and Health Reporter
Jaclyn Cosgrove writes about health, public policy and medicine in Oklahoma, among other topics. She is an Oklahoma State University graduate. Jaclyn grew up in the southeast region of the state and enjoys writing about rural Oklahoma. She is...
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There's stress on the people who are in the program going, ‘Do I enroll for another year? Do I not enroll for another year?' They're having to make decisions on something that, right now, all I can say is temporary.”

Nico Gomez,
Oklahoma Health Care Authority CEO

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