‘Qualifying’ Questions Remain Because Oklahoma Delayed Insurance Exchange

• Joe Wertz
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  Joe Wertz was a reporter and managing editor for StateImpact Oklahoma from 2011-2019. He reported on energy and environment issues for national NPR audiences and other national outlets. He previously worked as a managing editor, assistant editor and staff reporter at several major Oklahoma newspapers and studied journalism at the University of Central Oklahoma.

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Protestors argue about the Affordable Healthcare Act outside the U.S. Supreme Court in June 2012.

Oklahomans who don’t have “qualifying” health insurance by 2014 will be taxed through recently Supreme Court-affirmed provisions of the Affordable Care Act.

The Tulsa World‘s Wayne Greene asks the obvious question: “Does your insurance qualify?”

Unfortunately, there’s no telling, and Oklahoma hasn’t even started the process of resolving that question.

Oklahomans who don’t have qualified health insurance will be taxed $95 or 1 percent of their taxable income — whichever is higher. The tax increases to $325 and 2 percent in 2015 and to $695 and 2.5 percent in 2016.

There are exemptions and a maximum tax penalty of $2,085 per family, but Oklahomans will have a hard time assessing their potential financial burden without knowing if the insurance plan they already have works.

The ACA spells out 10 areas that health insurance must cover to qualify, but specific details are left to the states. State Deputy Insurance Commissioner Mike Rhoads tells the World that — currently — there isn’t a mechanism for figuring out the details on what a qualifying insurance plan in Oklahoma would contain.

That clarifying “mechanism” is a state health insurance exchange, which the “Oklahoma Legislature has balked two years in a row” to establish, the World reports. Gov. Mary Fallin wants to wait on the exchange until after the November election, but current federal law will impose an exchange on Oklahoma either way.

… either one established by the state, one imposed by the federal government or a hybrid with some tasks done by the state and others by the federal government, the World reports.

If the federal government sets up the state’s exchange, the U.S. Department of Health and Human Services has announced that it will use the small-group plan with the largest enrollment in the state as the default benchmark. In Oklahoma, that would be Blue Cross Blue Shield.