The state will send letters within the next two weeks to about 8,000 Oklahomans to let them know they will be dropped from the Insure Oklahoma health system at the end of the year.
They will be given contact information for the federal Health Insurance Marketplace, which is being created under the Affordable Care Act, or Obamacare, as a way for people to shop for government-subsidized health insurance beginning Oct. 1.
“We can't assist them in the application for the federal program, but we can point them in the right direction,” Nico Gomez, chief executive of the Oklahoma Health Care Authority, said Thursday. “It's our intent to point them in the right direction, whether it's a website, telephone number or a real person navigator, we want to make sure they have those resources available to them.”
These “navigators” are a group of community action centers and health centers that have received federal grants to help people who do not have health insurance but make too much money to qualify for Medicaid.
One of the organizations that will be working as a navigator is the Little Dixie Community Action Agency, which is a consortium of 15 different organizations across the state. According to planning director Rhonda Teague, while they have never specialized in helping citizens find health insurance, they have always primarily worked with low-income Oklahomans.
“Someone has to be able to help these individuals,” Teague said.
Gov. Mary Fallin announced Sept. 6 that the federal government had agreed to extend the Insure Oklahoma program until the end of 2014. That extension comes with some compromises.
As of Jan. 1, 2014, applicants must be at or below the federal poverty level in order to qualify for the program. The current eligibility is twice the poverty level or below. The federal poverty level is $23,550 annually for a family of four.
Fallin rejected expanded Medicaid funding from the federal government, saying the state's portion of expanded Medicaid under Obamacare would be too costly for the state.
She has also criticized the federal health exchange. The governor's office and the health care authority do not plan to provide education or assistance on the federal program beyond simply providing contact information.
“We're certainly in favor of letting them know what their options are and letting them know that they're not going to be left without any options,” said Alex Weintz, Fallin's spokesman. “But the governor would like to keep Insure Oklahoma unchanged, and it's not optimal that the federal government has demanded these people be dropped from a program that is already working, but that's why it's a negotiation.”
Insure Oklahoma has a cap of 35,000 participants and has never reached that limit. Once those 8,000 people are dropped, the program will insure roughly 21,000 Oklahomans.
Gomez estimates anywhere from 150,000 to 250,000 Oklahomans currently qualify for the program but make too much money to qualify for SoonerCare, Oklahoma's version of Medicaid. If and when the cap is reached, the health care authority has the option to either re-evaluate its finances and consider expanding the number of participants or creating a waiting list.
Starting next year, people will be required to pay an annual fee if they remain uninsured. The fee is $95 per adult and $47.50 per child, with a $285 cap per family or 1 percent of family income, whichever is greater. Those fees will rise dramatically over the following two years.