TRANSCRIPT
Dick Pryor: This is Capitol Insider - taking you inside politics, policy, and government in Oklahoma. I'm Dick Pryor with Quorum Call publisher, Shawn Ashley. We're going to start today with a complicated but important development that has real-world consequences for a large number of Oklahomans. Health insurance premium rates for state employees. The Oklahoma Employees Insurance and Benefits Board has approved increases that go into effect January 1st. Shawn, how are the rates determined?
Shawn Ashley: The Oklahoma Employees Insurance and Benefits Board makes rate recommendations for the Health Choice plans, the health insurance plans operated by the State of Oklahoma, based on a review of projected medical and pharmacy claims, health care utilization, and other factors affecting the cost of providing those benefits. The board's recommendations are first reviewed by the Oklahoma Health Care Authority chief executive officer and then given final approval by the Office of Management and Enterprise Services executive director. Premiums for Health Choice High, the most popular of the state insurance plans, will increase 15.8% under the rates approved earlier this month. The other Health Choice plans’ premiums are increasing even more, up to 19.5%.
Dick Pryor: Why are health insurance premiums going up?
Shawn Ashley: Office of Management and Enterprise Services Director Mark Wood, who gave the rates their final approval, said “the adjustment in Health Choice premium plans was necessary since prior year premiums have not kept up with the increases in health care costs.” One year ago - in 2025 - OMES asked Health Choice to re-examine its proposed rates for the current plan year and that resulted in no increases in the premiums, which essentially pushed those increases into the upcoming year's rates.
Dick Pryor: So, who pays for the premium increases?
Shawn Ashley: The costs are shared by the employee and the state. State employees receive a benefit allowance to cover the cost of all or part of their benefits, depending on exactly which coverages they choose. The premium increases will trigger an increase in that benefit allowance for state employees.
Dick Pryor: What does this increase mean for state entities? Where are they supposed to get the money?
Shawn Ashley: That’s really the untold story here. State agencies and colleges and universities were not appropriated additional funds in anticipation of the benefit allowance going up. So, they will have to figure out how to absorb that increase. In effect, it’s a budget cut for them.
Dick Pryor: Now, given Oklahoma's consistently low national rankings in healthcare, near the bottom among all states, is there anything the legislature can do about rising premiums and ultimately the cost of healthcare?
Shawn Ashley: In the short term, the legislature could consider supplemental appropriations for state agencies when it convenes in 2027. That would address the challenges some may face from the benefit allowance increase resulting from the rising premiums. In the long term, addressing rising health insurance premiums is a much bigger discussion about the underlying health care costs that drive up those premiums.
Dick Pryor: Over the last year or so, have you heard among legislators any desire to do something about those big issues?
Shawn Ashley: They have talked about a number of issues, such as the healthcare workforce, the increases in pharmacy cost and pharmacy benefit managers, and a number pieces of legislation have been enacted. But we have yet to see premiums in Oklahoma decline, not only in the private market, but, as we're seeing here in the public sector, they continue to increase.
Dick Pryor: This is an election year so voters will get to choose legislators and other officials who will have to deal with health care in the next session and beyond, and the Oklahoma primary runoff election is Tuesday.
Shawn Ashley: In statewide races there are four Republican runoffs and one Democrat runoff, in addition to around 15 local legislative runoff races. There are also two state questions for voters to consider. So, every voter, regardless of party affiliation, can vote on Tuesday in the runoff election on those state questions.
Dick Pryor: What else is going on at the Capitol right now?
Shawn Ashley: We're gearing up seriously for interim studies. A number have been scheduled through the remainder of August into September, and we're even seeing some planned for October at this point.
Dick Pryor: Thank you, Shawn.
Shawn Ashley: You're very welcome.
Dick Pryor: For more information, go to quorumcall.online. You can find video of Capitol Insider segments on the KGOU You Tube channel. Audio and transcripts are at kgou.org. And look for Capitol Insider where you get podcasts. Until next time, with Shawn Ashley, I'm Dick Pryor.
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