The Edmond Sun

Local News

August 29, 2012

State high-risk pool director speaks on insurance

ENID — As Oklahoma lawmakers watch and wait to see the outcome of November’s election before making any decisions on implementing “Obamacare,” one element of the plan already is fully operational in the state.

Tanya Case, executive director of Oklahoma Temporary High Risk Pool, was in Enid Monday to discuss the health insurance plan, which is designed to cover people with pre-existing medical conditions.

The temporary pool was established in Oklahoma in September 2010, in accordance with the Affordable Care Act. States that did not establish their own temporary pool had one established for them by the federal government.

If the Affordable Care Act remains intact, commercial insurance carriers will not be permitted to exclude people from coverage due to pre-existing medical coverage.

“We all know this is a very political issue,” Case said, “and based on the outcome of the election, it might change, but right now, this is set to go active Jan. 1, 2014.”

In the meantime, the temporary high-risk pool exists as a bridge to cover uninsured people with pre-existing conditions until the ACA provision takes effect.

Case said the temporary high-risk pool is not designed to provide insurance for low-income individuals and families, who would qualify for Medicaid and/or Medicare.

“This is designed for people who, based on their income, could afford insurance, but can’t get it on the commercial market because of a pre-existing condition,” Case said. “You can be excluded from having medical insurance for being just a little overweight. The commercial insurance carriers are very cautious about signing on anyone with a pre-existing condition.”

Of the estimated 650,000 Oklahomans without medical insurance, “not all of those people are living in poverty,” Case said.

In fact, she said, the majority of uninsured Oklahomans earn too much money to qualify for Medicaid or Medicare, and are uninsured because of pre-existing medical conditions or inability to pay premiums for commercial insurance.

She said only about 250,000 of the 650,000 uninsured people in Oklahoma qualify for Medicaid, “and that leaves a ton of people who are not low-income who don’t have insurance.”

Oklahoma made its own effort to insure those with pre-existing conditions long before “Obamacare” crossed the horizon. Lawmakers implemented a state high-risk insurance pool in the late 1990s, a plan that still is in effect.

But, the state high-risk pool comes with a higher price tag for the insured — in many cases, the premiums are twice as much as the temporary high-risk pool.

The ACA provisions anticipated customers’ desire to depart the more expensive state plan in favor of the cheaper, federally funded temporary high-risk pool.

Case said federal law prohibits the insured from “jumping ship” and leaving state programs to enroll directly in the ACA-mandated pools.

In order to deter this, people must have been without any health insurance for at least six months before they can sign up for the temporary high-risk pool.

Still, the costs of the program have surpassed the original budget, even though fewer people have signed up than originally planned.

Case said the ACA provisions planned for 300,000 to 350,000 people to sign up for temporary high-risk pools, also called Pre-existing Condition Insurance Plans.

Only about 100,000 have signed up nationwide. Enrollment in Oklahoma likewise has fallen below expectations.

But, Case said, the cost of covering those who have signed up has been higher than expected, because “the people joining the pool were so very sick, and their claims were so catastrophic.”

The federal government originally allocated $60 million to implement Oklahoma’s high-risk pool. That figure has since ballooned to $77.64 million to cover about 1,400 Oklahomans until the ACA guidelines take effect in 2014.

While the cost of the high-risk pool is significant, supporters contend the cost of leaving people uninsured is higher, and ultimately ends up being covered by taxpayers and members of commercial insurance plans.

“When a patient shows up in the emergency room a complete train wreck because they’ve never had insurance and never had health care, it ends up costing more and is worse for that patient,” said Kyle Whitehead, owner of Evans Drug Center and a board member for Oklahoma Health Insurance High Risk Pool. Whitehead co-sponsored Case’s talk in Enid at Autry Technology Center, along with Chad Caldwell, executive director of Hospice Circle of Love.

“It’s a lot better for everyone if we can get that person covered before that,” Whitehead said, “so they’re healthier, so they have better outcomes and it’s better for medical professionals.”

Whitehead said he and Caldwell wanted more people to be aware of the temporary high-risk pool.

“We’re all Enid people, and as members of the community, we know there are groups of uninsured people out there, and we just wanted to get this message out there,” Whitehead said. “It helps the hospitals, it helps the patients ... it helps the whole community.”

Caldwell echoed the public service value of Case’s presentation.

“If we can do something that benefits the community ... that’s why we exist,” Caldwell said. “Whether it’s the health care professionals or insurance providers, when Enid benefits, we all benefit, and that’s why we’re here today.

“I think one thing we have to overcome is, there are a lot of people who don’t have insurance and don’t know about the resources available to them. One of the worst things, something we’re trying to avoid, is the situation where someone is not getting the care they need because they’re not aware of the resources available to them.

“I think most people want to be able to pay for their medical care. If this is a way we can improve their care, and relieve some of that financial burden for the health care providers, then it benefits everyone.

“There’s no such thing as totally free health care. Somebody has to pay for that, and the overall health care system works better for everyone if as many people as possible are paying into the system.”

For information on the Oklahoma Temporary High Risk Pool, go to or call (877) 885-3717.

Text Only
Local News
  • 1,000th baby group.jpg INTEGRIS welcomes 1,000th birth since opening in October 2011

    Being the father of a new baby boy is pretty exciting, but being the father of INTEGRIS Health Edmond’s 1,000th baby made it even more special.
    “When we got to the hospital, the night-shift nurse told us we were in a race with another couple who had gotten there at 7 a.m.,” said Bryan Lane, the new baby’s father.

    July 31, 2014 1 Photo

  • okco fair 100.jpg Oklahoma County Free Fair offers competition, free fun

    Oklahoma County residents are invited to compete in the 100th annual Oklahoma County Free Fair as they take part in many activities scheduled just for them.
    The county fair will get underway Aug. 21-23 at the Oklahoma State Fair Park and will be highlighted by its open adult and youth along with 4-H and Oklahoma Home and Community Education categories, as well as its special contest and activities.

    July 31, 2014 1 Photo

  • Great Expectations names 4 Edmond public schools ‘Model Schools’

    Great Expectations, a non-profit foundation that provides intensive professional development to teachers and administrators, announces four Edmond Public Schools have earned the organization’s highest distinction: Model School. Based on Great Expectations theory implementation, there are three categories of recognition, including Transitional School, Progressive School and Model School.

    July 31, 2014

  • Grieving children find support at Calm Waters

    Calm Waters Center for Children and Families offers free support groups for children, ages 3–18 and their families whose lives have been affected by death or divorce.
    Oklahoma continues to rank among the top states in the nation for unintentional and premature deaths, leaving single parents raising children. Additionally, Oklahoma continues to have one of the highest divorce rates per capita in the nation. These tragedies leave children feeling isolated, sad, and uncertain.

    July 31, 2014

  • Church hosts adult Vacation BIble School

    “Jesus is the Source” will be the theme of Edmond First Church of the Nazarene’s second annual adult Vacation BIble School.
    The progam will be from 6-8:30 p.m. Aug. 4-7 at the church, located at 3001 S. Boulevard. It will include a light supper at 6 p.m. and songs, games, storytelling and crafts beginning at 6:30 p.m.
    Presenters will include members of the congregation acting as Bible characters and a special performer will be in from Texas.

    July 31, 2014

  • officers killed 1.jpg 67 cops die on duty across country

    The National Law Enforcement Officers Memorial Fund reports that 67 officers have been killed in the line of duty during the first half of 2014 — a 31 percent increase from the same period last year.
    Of these 67 officers, 26 were killed in traffic-related incidents, 25 were killed by gunfire and 16 died due to job-related illnesses and other causes. California led all states with eight officer fatalities followed by Florida, New York, Texas and Virginia each with four peace officer fatalities.

    July 31, 2014 2 Photos

  • Lankford, James 2011.jpg Lankford, rest of Oklahoma delegation vote to sue president

    A Democratic leader said the House does not have standing to sue the president after members of Oklahoma’s congressional delegation voted to do just that.
    At 6:28 p.m. Wednesday, members of the House approved by a 225-201 partisan margin H. Res. 676, which gives House leadership the authority to file a lawsuit challenging actions by President Barack Obam

    July 31, 2014 1 Photo

  • UCO, local Y create community garden

    A new community garden is providing a transformative learning opportunity for students and helping stock UCO’s Central Pantry.
    The University of Central Oklahoma’s Volunteer and Service Learning Center and the Edmond Rankin YMCA are sponsoring the garden, providing a transformative learning opportunity for students, and organic fruits, vegetables and herbs for the food bank.

    July 31, 2014

  • MS_prisons 1.JPG DOC action could save $36.8 million annually

    The Oklahoma Department of Corrections expects to avert more than 2,100 offenders by 2021 saving more than $36.8 million annually, an audit states.
    Tuesday, State Auditor and Inspector Gary Jones  released the results of a performance audit of the DOC that was requested by Gov. Mary Fallin. The audit for the period July 1, 2007 through June 30, 2013, distinctly focused on governance, financial management and capacity management.
    Audit recommendations included:

    July 30, 2014 2 Photos

  • food bank.jpg Regional Food Bank receives donation

    At a special celebration event Wednesday, Walmart and the Walmart Foundation announced that over the last fiscal year they gave more than $30 million in cash and in-kind contributions to charitable organizations throughout Oklahoma. Additionally, the retailer and its Foundation have partnered with local food banks to provide more than 15 million pounds of food to residents.

    July 30, 2014 1 Photo

Featured Ads
NDN Video
Famous Internet Cats Help Big Cause With Viral Video Recapping a Blockbuster MLB Trade Deadline Chapter Two: Composing for a film in retirement Is Justin Bieber Dating a Model? Guardians of the Galaxy (Trailer) 'Sharknado 2:' Hottest Memes Surfing The Net Raw: Obama Gets Hug From Special Olympian Snoop Dogg Narrating Animal Footage Is Perfect Tigers Acquire David Price - @TheBuzzeronFOX Russell Brand Slams Sean Hannity Over Gaza Conflict Segment Woman's Dive Goes Terribly Wrong Brian Williams Reports on Daughter Allison Williams' 'Peter Pan' Casting News Did Jimmy Fallon Look Up Heidi Klum's Dress? What Drama? Miranda Kerr Poses Topless Plane crashes in San Diego Costco parking lot Justin Bieber Takes To Instagram To Diss Orlando Bloom You Won't Believe the Celeb Cameos in "Sharknado 2" Pitch Invading Morons Cause Chaos - @TheBuzzeronFOX Orlando Bloom 'Takes a Swing' at Justin Bieber In Ibiza Sadie Doesn't Want Her Brother to Grow Up

The runoff race for the 5th District congressional seat is set for Aug. 26. If the voting were today, which candidate would you support?

Al McAffrey
Tom Guild
     View Results