Oklahoma Releases Draft ACA Section 1332 Waiver; Reinsurance Plan Could Cut Premiums Up to 14.6% From 2028
OKLAHOMA CITY — The Oklahoma Insurance Department on October 8 released a draft Affordable Care Act Section 1332 State Innovation Waiver for public review and comment, the first step toward a state-run reinsurance program aimed at lowering health insurance premiums in the individual market starting January 1, 2028.
The department intends to submit the waiver application to the federal government this fall. According to the draft, the reinsurance program is projected to reduce premiums between 4.1% and 6.4% statewide, with reductions of up to 14.6% in high-cost regions of the state where few insurers participate.
"Submitting Oklahoma's 1332 waiver application is an important step toward making health insurance more affordable for Oklahoma families," said Insurance Commissioner Glen Mulready. "Oklahomans continue to feel the pressure of rising health care costs, and we have an obligation to pursue every responsible tool available to help bring premiums down. This waiver gives Oklahoma an opportunity to develop solutions tailored to our state rather than relying on a one-size-fits-all approach. Our goal is straightforward: create greater stability in the individual market, lower costs for consumers and build a stronger, more sustainable health insurance market for Oklahoma."
The backdrop is years of instability. Since the Affordable Care Act took effect, Oklahoma's individual health insurance market has struggled with declining enrollment, high premiums, and limited insurance company participation — problems that have hit rural and high-cost regions especially hard, leaving some residents with few or no choices of insurers.
Section 1332 of the Affordable Care Act allows states to seek federal approval to try alternative approaches to certain federal health insurance requirements, as long as they meet federal guardrails on coverage, affordability, comprehensiveness, and federal spending. Reinsurance — in which the state helps insurers cover the costs of their most expensive enrollees — is one of the most common uses of the waiver, and multiple states have used it to bring premiums down.
Oklahoma is now asking the public to weigh in. Written comments on the draft waiver are being accepted through October 31, 2026, by email at [email protected] or by mail to the Oklahoma Insurance Department, Attn: State Based Exchange / 1332 Waiver, 400 NE 50th Street, Oklahoma City, OK 73105.
The state will also hold three public hearings at the Oklahoma Health Care Authority, 4345 N. Lincoln Blvd. in Oklahoma City, with virtual attendance options: Public Hearing #1 on October 13 at 2:00 p.m. CT, Public Hearing #2 on October 14 at 11:00 a.m. CT, and a hearing for members of Oklahoma's Tribal Nations on October 22 at 10:00 a.m. CT. Registration information is available on the Insurance Department's website.
If the waiver is approved on the state's timeline, the reinsurance program would take effect for the 2028 plan year — meaning Oklahoma families shopping for individual coverage could see relief in the premiums they pay starting in just over a year.
Published by GSM · USA (original Chinese edition)
Photo: CC0（Wikimedia Commons，Oklahoma Legislative Services Bureau）
