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 www.bcbsok.com/ohrp or call (877) 885-3717.

1
Text Only
Local News
  • Oak Tree Official offers glowing update on Senior Open

    An official who has been in charge of tournaments since 2001 said the 2014 U.S. Senior Open is probably the best city event partnership he has seen.

    April 18, 2014 1 Photo

  • Edmond soldier settles in housing benefits case

    U.S. Attorney Sanford C. Coats said Thursday a U.S. Army reserve soldier from Edmond has agreed to pay the government $20,000 to settle civil claims related to obtaining fraudulent housing benefits.

    April 17, 2014

  • Stevenson 1 Oklahoman returns home focused on pro-gay agenda

    Troy Stevenson remembers the day when football players discovered him and his boyfriend holding hands behind an Edmond high school. After they had been chased off school property, Stevenson, called to check on his boyfriend.
    “He was in hysterics,” Stevenson said. “… Like me, I thought he was scared. Did people see us? What would people think?”

    April 17, 2014 2 Photos

  • Lawn Experts’ tips can help your lawn bounce back

    Chances are your lawn is looking a bit bedraggled after this rough winter.
    That’s not surprising. Between brutally cold temperatures and drying winds, turf took a beating this year.

    April 17, 2014 1 Photo

  • Gracelawn grows larger

    The Edmond City Council voted 5-0 in favor of the city purchasing 20.5 acres of land immediately to the north of Gracelawn Cemetery. Purchasing the property is needed for future expansion of the cemetery, Mayor Charles Lamb, said.
    Gracelawn Cemetery is owned and operated by the city and is located on the northwest corner of Danforth and Boulevard.

    April 17, 2014

  • Warmth needed to grow tomatoes

    The time for those growing tomatoes in their garden is when the soil temperature is above 60°F and fear of frost has past. We are generally safe from frosts after April 5.  However, frosts have occurred as late as May 1 in the Oklahoma City area. If you planted your tomatoes on or before April 5 last year you would have covered them several times as there were several late frosts. If you plant early, be ready to cover your plants during nighttime frosts.

    April 17, 2014

  • Debate Senate hopefuls meet in first debate

     Accountability to the American people and the $17.5 trillion debt continues to be a major issue in the race for U.S. Senate office being vacated by retiring U.S. Sen. Tom Coburn.
    The Oklahoma Conservative Political Action Committee hosted a debate Wednesday for three of the seven Republicans running for the U.S. Senate seat that is being vacated by retiring U.S. Sen. Tom Coburn.

    April 16, 2014 1 Photo

  • Oklahoma City FC invites fans to design club scarf

    Oklahoma’s top-tier soccer club, Oklahoma City FC, invites soccer fanatics across Oklahoma to be a part of its future by designing its scarf.
    Scarves are a tradition among soccer clubs and are typically a team’s most recognizable accessory. Scarves are a matter of pride for hard-core supporters and feature team colors, logo and inspiring slogans. Scarves are a part of a team’s identity.

    April 16, 2014

  • MS_injection well.jpg Agency clarifies earthquake-related misinformation

    A state agency says misinformation related to the debate about the cause of more earthquakes across Central Oklahoma includes oil well types, well numbers and injection pressure.
    The Prague sequence of 2011 along the Wilzetta Fault zone included a significant foreshock, a main shock of magnitude 5.7 and numerous aftershocks. It has been suggested that this sequence represents tremors triggered by fluid injection.
    More recently, earthquakes have been recorded in the vicinity of Jones, Arcadia Lake, Edmond, Guthrie, Langston and Crescent. Regulators and scientists are working together to better understand what’s causing all the shaking.

    April 16, 2014 1 Photo

  • Sheriff seeks items for agency history project

    If you have historic pictures or artifacts related to the Oklahoma County Sheriff’s Office, the agency is asking the public to share them.
    “The Oklahoma County Sheriff’s Office is working on a history project. If you, your family, friends or acquaintances have any old photos or artifacts related to the OCSO we would love to have them or a digital copy,” said Oklahoma County Sheriff John Whetsel.

    April 16, 2014

Featured Ads
NDN Video
Man Accuses 'X-Men' Director Bryan Singer of Sexually Abusing Him As a Teenager Lea Michele & Naya Rivera Feuding? Don't Be A Tattletale: Bad Bullying Tips For Students Jabari Parker declares for the NBA draft Singing Nun Belts Out Cyndi Lauper New West, Texas Explosion Video Swim Daily, Throwback Thursday The trillest thoughts on marijuana "RHOA" Star Charged With Battery Grizzly Bears Get Snowy Birthday Party Weatherman draws forecast when another technical glitch strikes WGN Elizabeth Olsen's Sexy Shoot Bay Area Teen Gets Prom Date With Help From 'Breaking Bad' Star Boston Bomb Scare Defendant Appears in Court Behind The Tanlines Jersey Strong Part 1 WATCH: Women Fight To Marry Prince Harry! Jenny McCarthy Engaged to "New Kid" Kate and Will Land in Oz O’Reilly Launches Preemptive Strike Against CBS Pixar Unveils Easter Eggs From its Biggest Movies
Poll

Do you agree with a state budget proposal that takes some funds away from road and bridge projects to ramp up education funding by $29.85 million per year until schools are receiving $600 million more a year than they are now? In years in which 1 percent revenue growth does not occur in the general fund, the transfer would not take place.

Agree
Disagree
Undecided
     View Results