AcademyHealth Stateside - 02/16/2005 (Plain Text Version)In this issue: Oklahoma submits HIFA Waiver to CMS
(from l-r): Derek Leiser, Matt Lucas, Alice Burton, Buffy Heater, and Isabel Friedenzohn on the steps of the state capitol with the OKHRA proposal to be submitted to CMS the following day. In mid-January, officials from the Oklahoma Health Care Authority (OHCA) submitted a new Health Insurance Flexibility and Accountability (HIFA) waiver to officials at the Center for Medicare and Medicaid Services (CMS) that outlines the state’s plan to establish a premium assistance program for small employers. Known as The Oklahoma Health Care Recovery Act (OKHRA), the plan was passed by the state legislature in 2004. OKHRA initially will be available for workers and spouses with household incomes at or below 185 percent of the federal poverty level who work in firms with 25 or fewer workers, including those that currently offer coverage. Unemployed individuals seeking work will also be eligible. Participating employers will be required to pay 25 percent of the cost of employee premiums. Employees will be responsible for up to 15 percent, and the state and federal governments will pay whatever is not covered by the employer/employee contributions. OKHRA will include a “safety-net” option for eligible workers and spouses whose employers are unable or unwilling to participate. These individuals will be permitted to buy directly into an insurance product offered by the state. Through OKHRA, the state will also begin to participate in the federal “Ticket to Work Incentives Improvement Act” by offering premium assistance to qualified working individuals with disabilities who are ineligible for Medicaid due to their employment earnings. The state plans to devote approximately $50 million per year to the initiative, to be generated through a new tobacco tax that took effect on January 1, 2005. “Our goal is to have this program operational by fall 2005,” said OHCA CEO Mike Fogarty. “By expanding access to health coverage, Oklahoma will make significant headway toward addressing the state’s insurance crisis.” When the program is fully operational, the agency expects to enroll up to 70,000 Oklahomans based on the current funding. On January 13, Alice Burton and Isabel Friedenzohn attended the last workgroup meeting for the Oklahoma State Planning Grant, where the final details of the waiver were presented to stake holders. |