The Oklahoma Insurance Department announced its plans to transition to a state-based Marketplace for Affordable Care Act coverage for 2028 open enrollment.
Currently, Oklahoma relies on the federal government for its marketplace, using HealthCare.gov as its enrollment platform. The state will join DC and 20 states, which have fully state-run Marketplaces. This means Oklahoma will operate its own website and contact center.
This transition was authorized last year in House Bill 1512, by Rep. Mark Tedford, R-Jenks, and Sen. Lonnie Paxton, R-Tuttle. The policy authorized the insurance commissioner to establish and operate a health insurance marketplace exchange and created a State-based Exchange Revolving Fund.
The department said in a press release this will allow Oklahoma to retain and reinvest revenue currently being sent to the federal government. The exchange will sit within the Oklahoma Insurance Department, and Deputy Commissioner for External Affairs Ashley Scott will serve as its director.
“I appreciate Commissioner Mulready trusting me with this opportunity and look forward to this new challenge,” Scott said in the release. “We are taking back control of our individual market and will better serve Oklahomans across the state with this effort.”
According to a notice from the department, Oklahoma will first function as a state-based exchange on the federal platform, with a target transition date of May 1.
This means Oklahomans will continue to enroll through HealthCare.gov for 2026 and 2027 coverage while the state manages public engagement and awareness, community assister programs, health plan management and a hotline to help consumers.
In November 2027, they will be able to shop for and enroll in plans for 2028 through the state-based exchange.
Years in the making
The transition is one Insurance Commissioner Glen Mulready has had his eyes on since he was a state lawmaker in 2011. Mulready told StateImpact he helped run a state-based exchange bill.
It didn’t go anywhere at the time, and when Mulready ran for reelection, he was accused of trying to “push Obamacare down Oklahoma’s throat.”
The topic, he said, was “politically toxic.”
“I think there were a lot of people that believed, ‘Hey, we didn't do a state-based exchange, so we stopped Obamacare at our border,’” Mulready said. “Well, we now know, of course, we did no such thing, right? We just ceded control to the federal government on the marketplace and how that all got handled.”
He said a state-based exchange will allow Oklahoma to issue more detailed data about its enrollment at a quicker pace.
Mulready also mentioned instances of fraud, such as when bad actors enrolled people into zero-premium plans without their knowledge. Now, he said, Oklahoma will have more control in such situations.
“At the time, all we could do was contact [the Centers for Medicare and Medicaid Services],” Mulready said. “CMS eventually did something, but it took 18 months, two years to do something about that.”
The department plans to pursue a Section 1332 State Innovation Waiver, which will allow it to create a state reinsurance program starting in the 2028 coverage year. These programs provide funding to insurers who cover consumers with high medical costs, preventing them from raising insurance premiums on all enrollees.
As of May 2024, 17 states have had reinsurance programs approved by CMS. The department said in its release it will support market competition and slow cost increases.
StateImpact Oklahoma is a partnership of Oklahoma’s public radio stations which relies on contributions from readers and listeners to fulfill its mission of public service to Oklahoma and beyond. Donate online.
