Lower-income workers who enjoy reduced monthly health insurance premiums because of their employers' participation in Insure Oklahoma celebrated Friday's announcement that the federal government is allowing a one-year extension to the state-federal premium assistance program that was set to expire Dec. 31.
“We heard the news this morning and all of us here are excited,” said Teri O'Hern, an office assistant with Stroud Health Care Center, which employs 71including nurse's aides, housekeepers and cooks.
“Half of our employees have insurance only because of Insure Oklahoma,” O'Hern said. “Without it, they'd never be able to afford it.”
At Cherokee Hills Veterinary Clinic in Oklahoma City, veterinarian assistant Tabitha Jones, 34, also cheered the news. “I'd planned to start looking for other insurance closer to the end of the year, but am glad I don't have to,” Jones said.
Under Insure Oklahoma, she said she pays less than $50 a month for insurance and has used it over the past two and half years “quite a bit,” including for counseling and chiropractor appointments.
Meanwhile, Cheryl McEvoy, a 55-year-old self-employed nail technician with a leased storefront in northwest Oklahoma City, mourned the state's concessions that came with Oklahoma's deal with the federal government.
Though plan criteria for the workers of small businesses that participate in Insure Oklahoma was left intact, income eligibility requirements for self-employed, unemployed and other individual participants were knocked to 100 percent of the federal poverty level or lower, down from 200 percent and below (or, starting next year, $11,490 for an individual; $23,550 for a family of four, compared with $22,980 and $47,100, respectively).
That leaves McEvoy, whose income exceeds the new requirements, to shop for health insurance on Oklahoma's new federally run online health insurance marketplace, which opens for enrollment Oct. 1.
“I was hoping I wouldn't have to shop around,” said McEvoy, who paid only $50 a month with Insure Oklahoma, compared with $350 a month and a $4,500 out-of-pocket deductible under a major medical plan she bought five years ago.
Larry Gundlach of Oklahoma Business Insurors said the difference is significant between what Insure Oklahoma participants pay for health insurance and what those same workers will pay, even with federal tax credits, on the new insurance exchanges.
Under Insure Oklahoma, workers pay no more than 15 percent of premiums, compared with roughly 50 percent for a worker who has an income below 200 percent of the federal poverty level and buys on the exchange, Gundlach said. Such a worker, on a $400 monthly premium, would pay $200 versus $60.
“Plus, Insure Oklahoma participants get a better plan that costs less,” he said.
“Employers who participate in Insure Oklahoma generally buy plans with richer benefits and lower deductibles, since the program covers the lion's share of the premiums,” Gundlach said.
Funded with state tobacco tax revenues matched with federal funds, Insure Oklahoma pays 60 percent of premiums for workers; 85 percent of premiums for spouses covered under the program.
Jo Kilgore, spokeswoman for the Oklahoma Health Care Authority, which administers Insure Oklahoma, said the program currently has 29,261 participants, including 15,956 covered under employer-sponsored insurance and 13,305 individuals. Come Dec. 31, some 8,000 will be kicked off Insure Oklahoma's individual plan became of the curtailed income eligibility requirements, Kilgore said.
Insure Oklahoma has a capacity of 35,000 — or effective Jan. 1, some 13,000 openings, she said.
About Insure Oklahoma
Established in 2005, Insure Oklahoma provides premium health insurance assistance to businesses with 99 or fewer employees and self-employed people by using state tobacco tax revenues matched with federal funds. Employees must meet age and income requirements, be Oklahoma residents, meet citizenship guidelines and pay part of the premium payments. Workers pay about 15 percent of the premium, while the employers pay 25 percent and Insure Oklahoma pays 60 percent. Spouses also may qualify through the program. Currently, 4,609 small businesses are participating including 15,956 workers and dependents. For more information, go to www.insure