The Oklahoma Insurance Department is gearing up for an exciting shift. By 2028, the state will launch its own Marketplace for Affordable Care Act coverage. Right now, Oklahomans use the federal site, HealthCare.gov to enroll. This move will bring Oklahoma into the company of 20 other states and Washington, D.C., which already manage their own marketplaces.
This transition was set in motion by House Bill 1512, thanks to Rep. Mark Tedford and Sen. Lonnie Paxton. It allows the insurance commissioner to create a health insurance exchange right here in Oklahoma, aiming to keep more revenue in the state. The Oklahoma Insurance Department will oversee this exchange, with Deputy Commissioner Ashley Scott at the helm.
Scott expressed her enthusiasm for the new role, stating, “We are taking back control of our individual market.” This change means Oklahomans will soon have a more customized experience when shopping for health plans.
Initially, Oklahoma will operate its state exchange on the federal system, starting May 1, 2026. Residents can enroll for coverage during 2026 and 2027 using HealthCare.gov. When November 2027 rolls around, they will be able to explore and enroll in plans through the state exchange for 2028.
Insurance Commissioner Glen Mulready has long envisioned this change. He attempted to push for a state-based exchange back in 2011 but faced political resistance. He noted that the narrative surrounding “Obamacare” made it a sensitive topic at the time. “Not having a state exchange didn’t stop Obamacare; it just gave control to the federal government,” he said.
This new state-run marketplace opens doors for better management and quicker responses to issues like fraud. In the past, fraudsters enrolled individuals in zero-premium plans without their consent. Now, with a state exchange, such cases can be resolved more efficiently.
The department plans to apply for a Section 1332 State Innovation Waiver. This could lead to a state reinsurance program starting in 2028. These programs help insurers by covering high-cost patients, which can keep premiums more affordable for everyone. As of May 2024, 17 states had received approval for similar programs from the Centers for Medicare and Medicaid Services.
In building a state-based marketplace, Oklahoma aims not only to control its healthcare landscape better but also to enhance competition and slow down rising costs. This is a crucial step as healthcare continues to be a hot topic across the country, with many states reevaluating their approaches.
