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OKLAHOMA CITY — For the first time, eight insurers have committed to selling health insurance through the state’s Affordable Care Act marketplace.

But, only two of those providers — Blue Cross Blue Shield and Medica — will offer health insurance plans in all 77 counties in 2022 through the Affordable Care Act’s Health Insurance Marketplace.

The exchange, which is supposed to decrease the number of uninsured, is designed to let consumers browse different policies to find the one that best fits their needs. Individuals may qualify for tax credits or government subsidies based on income to help cover the costs of plans purchased through the exchange.

Mike Rhoads, deputy commissioner of consumer assistance with the Oklahoma Insurance Department, said some carriers are coming into Oklahoma “a little bit cautiously” and are requiring their consumers to live primarily in the Tulsa and Oklahoma City areas, but said rural consumers still should be able to find an insurance plan at a price comparable to their urban counterparts.

He said a 40-year-old nonsmoker, who selects the lowest cost Medica or Blue Cross plan with a $1,500 to $2,500 deductible could expect to pay an average of $480 to $490 a month, which is slightly lower than in 2021. He said monthly rates are lower for younger residents, higher for older ones.

In comparison, Rhoads said benefit packages offered in urban areas are within about $10 of that price.

About 170,000 Oklahomans were covered through the marketplace in 2021, up 8% from the year prior, Rhoads said. Nearly 95% of enrollees in the state’s marketplace receive some sort of governmental subsidies. Some individuals pay as little as 5% of those costs, Rhoads said.

Prior to Medicaid expansion in July, about 14.5% of Oklahomans — or about 550,000 — were uninsured. Following expansion, the state’s uninsured rate dropped to 11.5%, he said.

Rhoads said officials still are waiting to see what impact Medicaid expansion will have on the insurance marketplace, but estimates indicate about 15% to 20% of current ACA enrolless would migrate to Medicaid because it’s a better deal.

Rhoads said Glen Mulready, the state’s insurance commissioner, has focused on bringing more competition into the state’s insurance exchange.

In 2017 and 2018, the state had just one carrier — Blue Cross and Blue Shield. In those years, the “uncertainty, the instability of the marketplace was pretty evident,” he said.

“We’re not necessarily older, but we are a little bit sicker,” Rhoads said. “We still have a high rate of smokers.”

Over the past four years, more insurers have been entering Oklahoma’s marketplace. State insurance officials are working to expand insurance offerings in rural Oklahoma, Rhoads said.

He said the increased competition is good for consumers because insurance providers typically are competing on price as well as benefits.

Richard Trussell, a community outreach specialist with Blue Cross Blue Shield, has been traveling the state enrolling Oklahomans in ACA plans. His team focuses the majority of its outreach on tribal, rural and Latino areas.

He said the company, which has been in the state for more than 80 years, serves a large percentage of Oklahoma’s ACA consumers.

Trussell said the marketplace was tough at the beginning because there needed to be more scope. Over the past few years, enrollment has been increasing, especially in the urban and metro areas. He also said government subsidies have increased and more Oklahomans are buying through the marketplace.

“Just the rates and then the number of people that are actually utilizing it now are making it more worthwhile for these out-of-state insurance companies to come in and try to start picking up people,” he said.

Geoff Bartsh, senior vice president for individual and family business at Medica, said when the nonprofit entered Oklahoma in 2019, it was only the second carrier to offer insurance on the marketplace.

“We believed it was important that all people had a choice of coverage regardless of where they live,” he said. “So we made a commitment to the state to offer coverage statewide. Our mission and our commitment to the entire state of Oklahoma still exists.”

Open enrollment runs through Jan. 15.

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