OK-SAFE, Inc. Blog

December 8, 2011

One Weird Meeting on Health Insurance Exchanges at the Capitol – Update and Correction!

12-9-11 Update and Correction  to this post –

We received a call today from Kate Richey of the OK Policy Institute, offering to correct some of the information in the post below, for which we are grateful.  Prior to this morning, information on who called this meeting was not exactly forthcoming.

Item #1- The OK Policy Institute did not sponsor this meeting on Health Insurance Exchanges.  Kate Richey was invited to speak by Claudia Kamas of Kamas Consulting, and Sandy Ruble of Rx Net,. (Kamas and Ruble are both registered lobbyists in Oklahoma).  According to Richey, the invitation to the meeting went out to several lists, not just the legislative assistants.  The purpose of the meeting was informational for those who missed the prior health care meetings.

Item #2 – Richey clarified her statement about who would run the exchanges to mean within the context of Medicaid expansion of coverage. The quotation marks have been removed, per her clarification.

Item#3 – We agreed to disagree on the statement that it doesn’t matter who establishes the insurance exchange or who governs it – either way it will be operating according to federal requirements.

OK-SAFE, Inc. 12/8/11 –

Off the record – it doesn’t matter who establishes the exchange or governs it – it will be run according to federal requirements. (In the context of Medicaid expansion of coverage, per Richey’s call  12/9/11)

“Utah is working to make their state compliant with the federal law.”

“Those are the only two choices available now – a state-run exchange, or a partnership with federal government.” Regarding the interim study just finished – there is one basic fact – if Oklahoma establishes a state-run exchange, it has to be basically compliant with the feds.  “If we do one poorly, we will end up with a federally facilitated exchange anyway.”   – Kate Richey, OK Policy Institute


For some reason that is still unclear, the progressive OK Policy Institute sponsored Claudia Kamas of Kamas Consulting, and Sandra Ruble of Rx Net, invited a member of the OK Policy Institute to speak at a meeting this morning on Health Insurance Exchanges in room 419-C at the Oklahoma State Capitol.   They invited only the legislative assistants. The invitations, according to Richey on 12/9/11, went out to several lists, not just legislative assistants. (OK-SAFE Note:  Sen. Stanislawski’s office did not know of this meeting until a day or so before the event.)

Both Kamas and Ruble are registered lobbyists in Oklahoma.

From the online view of the meeting, however, it looked like several of the attendees were not legislative assistants.  Lobbyists?

Not Part of the Joint Committee

This meeting was not part of the Joint Legislative Committee meetings on Federal Health Care Reform Law held earlier, and which concluded on November 15, 2011.

The speaker was Kate Richey, hired by the OK Policy Institute in January 2011, who gave a somewhat rambling presentation on the provisions of the Affordable Care Act and the requirements for the Insurance Exchanges.

Blame the Tea Party!

When it came to the discussion of the federal timelines, and the grants, a couple of men attendees complained about  “the Tea Party” causing the establishment grant money to be rejected.  (One can only assume they meant the Early Innovator Grant, rejected by the Governor in March of 2011, after first accepting it.)

(The term “Tea Party” is thrown out there randomly by people who are generally unfamiliar with the conservative grassroots efforts in this state.  It’s another way of saying,  “There are organizations and groups out there I know nothing about so I’ll just call all of them Tea Partiers.” )

The questioner would be more accurate if he meant the 65% of Oklahomans who rejected the implementation of “Obama Care” in this state caused the rejection of the establishment grant – then he’d be right.

A few of the notes from Richey presentation, 12/8/11 –

  • Question from attendee on the governance of exchange.
  • Richey – No opinion on which form is best.  Wait until the state moves forward with legislation.  Each model has their pros and cons.  “We need to take action and move forward.”
  • On Feb. 29, 2011 the federal government issued some answer in the form of Q & A on State Exchanges.  Is OK ready to run an exchange by Jan. 2013?  The exchanges have to launch by 2014, so has to be “beta ready” by Oct. 2013.
  • Regarding states not being ready – “the feds are willing to meet you where you are and walk with you through the exchange.  If we turn down establishment grants, there is money still out there.  If we miss the deadlines the funds will still be available.
  • Question about grants – Yes, they will be available on a rolling schedule through 2014.
  • Question: Where is the advocate in Oklahoma for the exchanges? Seems like we got derailed by the Tea Party they just didn’t want the state to commit…? 
  • We’re working on the governance structure.
  • Not sure why the money was returned.  Will have to reapply for another establishment grant.
  • Comment from attendee: NAHU (National Association of Health Underwriters) are behind (advocate) it.  The OHCA working groups are active.  We were sad to see those funds return.  The Tea Party blocked it.
  • There were groups there at the beginning, various advocates.
  • Feds will set up exchange if they need to, but they don’t want to run it for long run.  Will eventually turn it back over to the states for most of the functions.  (Except data hub?)
  • Grant agreements come with benchmarks that must be achieved. “Even if we miss the deadlines on these grants the money will still be available until 2014.”  As far as Richey knows no one has applied for a Level 1 or Level 2 grant.  “Even if we move ahead there will be some level of federal involvement.”
  • There is a tentative federal-state partnership plan being developed.  There will be some sharing of some responsibilities.  Feds will regulate, run the hotlines, operate data hub.  It will take more planning, some sort of partnership model.
  • Those are the only two choices available now – a state-run exchanges, or a partnership with federal government.
  • Regarding the Interim study just finished – there is one basic fact – if Oklahoma establishes a state-run exchange, it has to be basically compliant with feds. If we do one poorly we will end up with a federally facilitated exchange anyway.
  • Health care reform requires the electronic health records infrastructure.  A group in NE Oklahoma is working to get the state compliant with the electronic information technology infrastructure.
  • OK’s High Risk Pool will be folded in to the state exchange for their coverage.

For the entire OK-SAFE notes on today’s Health Insurance Exchange meeting, a pdf is available here.

For the real definition of Health Care Reform see this OK-SAFE post

So, Who Gets the Grant Money Now?

The question that is on the table is this – has there been a move to change the State Designated Entity (SDE), overseeing the distribution and use of the federal grant money, from being the Oklahoma Health Care Authority (OHCA) to the Oklahoma Health Information Exchange Trust (the OHIET)?  This Trust is working behind the scenes to implement the information technology provisions of the Affordable Care Act (“Obama Care”) in this state, and has already been instrumental in awarding contracts.

Despite the wishes of the people of Oklahoma.

Richey PPT –

Supposedly, the Kate Richey/OK Policy Institute power point presentation will be available online at some point in time via their website – http://www.okpolicy.org .   As of this writing, it is not yet posted.

In the meantime, keep calling your legislators and tell them “Oklahomans said No to Obama Care in 2010” – and we still mean No!

OK House: 1-800-522-8502

OK Senate: 1-800-865-6490

For contact information for the OK House members, click here.  OK Senate members, click here.

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