Oklahoma’s tenuous presence in the federal individual health insurance exchange has been made more so by the uncertain political and regulatory environment, state Insurance Commissioner John Doak said Friday.
“I have an obligation to keep people informed,” he said by telephone.
Doak was clarifying an earlier statement that Oklahoma was in danger of not having any individual policies available on the federal exchange come 2018.
Only one carrier, Blue Cross and Blue Shield, currently offers polices in Oklahoma through the exchange.
In an emailed statement, Blue Cross and Blue Shield of Oklahoma said: “No final decisions have been made regarding our 2018 product offerings or participation.
“While some carriers have chosen to exit the market in 2017, we continue to provide quality health insurance options for Oklahomans while working with state and federal regulators to ensure a stable and sustainable insurance marketplace for our members.”
In the telephone interview, Doak said he’s had no indication Blue Cross and Blue Shield will drop out, but that his earlier statement was meant to impress upon lawmakers that the situation could deteriorate very quickly.
“This is a serious issue,” he said.
Doak and Deputy Commissioner Mike Rhoads said Congress’ inability to agree on a repeal and/or replacement bill for the Affordable Care Act further clouds the situation.
“These carriers are looking for guidance,” Rhoads said. “They are looking for clarity.”
Under existing law, insurers are supposed to submit 2018 rates in June. Rhoads said it’s difficult to formulate those rules in the current environment.
Doak’s original statement was made in support of a state Senate bill that would allow the sale of health insurance across state lines, a move some tout as a way to lower premiums.
The savings, if any, would come at least in part from circumventing or reducing state coverage mandates. Oklahoma’s, for instance, include requirements related to coverage of autism, colorectal and breast cancer screenings and children born out of wedlock, to name just a few. Each mandate adds in some way to premium costs, analysts say.
The health insurance exchange, meant to cover those required to buy insurance under the Affordable Care Act, has had a tough time finding carriers in Oklahoma. That’s because Oklahomans — especially those who haven’t had insurance — are too unhealthy for carriers to make a profit given the ACA’s parameters.
“They can’t make it work financially,” said Rhoads. “The people who take it typically have higher utilization.”
If all or part of Oklahoma were to be left without a commercial carrier, Rhoads said, current law calls for the federal government to offer a “public option.”
“That’s very problematic,” Rhoads said. “I don’t think the federal government has given much thought to how that would work.”
Date: March 26, 2017