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Exchanging control



Among the most immediate concerns is the state’s requirement to have a health care exchange. Under ACA, all states must have an electronic database that connects people buying insurance coverage to insurance providers, as well as information about what federal subsidies are available to them.

Failure to create an exchange by Jan. 1, 2014, would cause the state to be subject to a federally created health care exchange.

The State Chamber of Oklahoma was one of several groups that assailed the high court’s 5-4 decision upholding ACA, known to its opponents as “Obamacare.”

“We are extremely disappointed in this decision,” said Chamber President Fred Morgan. “We now face a situation where a health insurance exchange crafted by bureaucrats in Washington, D.C., will now be forced upon Oklahomans. We cannot let this happen and must take swift action to create a private-sector-driven health insurance marketplace in order to avoid a federally mandated system.”

The state last year accepted a $54.6 million federal grant to help pay for setting up the system, but Gov. Mary Fallin later decided to return the money after criticism from conservative groups and lawmakers.

Meanwhile, the Legislature declined to take action on a bill to set up a partial health care exchange (excluding the connection service of insurance buyers to federal subsidies), Senate Bill 1629, instead opting to wait until a Supreme Court ruling on the issue.

Now that a ruling has been handed down on what Fallin called “a bad day for all Americans,” the governor said she probably will not call a legislative special session to create such an exchange. While a number of states are in the same position as Oklahoma, a few have had the governor’s office establish such exchanges.

Fallin said she and her legal team will evaluate the state’s options. In the meantime, she said she hopes Republicans win both the presidency and Congress in the November elections so the law can be repealed.

According to the Oklahoma Hospital Association, around 18 percent of the state’s population is uninsured. Supporters of the Affordable Care Act say the law will help the uninsured obtain coverage, as well as prevent insurance companies from denying coverage to individuals with pre-existing medical conditions or dropping coverage if the individual gets sick.

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