BY JOE DORMAN

Many Oklahomans are struggling to meet the needs of health insurance coverage. Insurance is a tricky and frustrating issue for most Americans. We are currently in open enrollment to adjust insurance plans. If you are not satisfied with your insurance policy, now is the time to review options. I encourage you to consult your insurance agent to see if you are getting the best benefit.

Many Oklahomans cannot afford insurance. One in six Oklahomans lived in poverty last year [annual income below $23,850 for a family of four], so this is significant for a large portion of our state. Oklahoma’s Medicaid program, known as SoonerCare, is administered by the Oklahoma Health Care Authority [OHCA] and remains a source of health care for low-income children, seniors and the disabled.

Every applicant must meet these three basic Medicaid requirements:

*Is a U.S. citizen or has a permanent legal immigrant status;

*Has a valid Social Security number;

*Is an Oklahoma resident.

SoonerCare services cover preventive, rehabilitative and emergency care, as well as treatment for pre-existing conditions. The state has devised a Health Management Organization [HMO] of doctors and facilities, as well as a fee-for-services network of medical care providers, that are paid directly from state funds.

2015 Oklahoma Medicaid income requirements are as follows:

One person = $11,770; two family members = $15,930; three family members = $20,090; four family members = $24,250; and five family members = $28,410.

Other groups of Oklahoma residents who qualify are pregnant women, children up to 19 years of age, seniors 65 and older, and persons with disabilities.

To see if you qualify, consult your county Human Services office. Call in advance to check if they accept appointments and their hours of operation, as each office is different. To ensure the SoonerCare application process is quick and smooth, ask for a list of items you should bring.

For small businesses, the good news is the grace period for our Insure Oklahoma program has been extended an extra year. This program was established by the Oklahoma Legislature in 2004 and authorized the OHCA to develop a program assisting employees of small businesses, 19 to 64 years of age with either [1] a portion of their private health plan premiums or [2] a state-sponsored health plan operated under SoonerCare.

The Oklahoma Health Care Initiative created the funding mechanism for Insure Oklahoma. SQ 713, passed by a vote of Oklahomans, increased sales taxes on tobacco products. A portion of these revenues is designated to fund the health program.

There is a push to accept the federal dollars offered under Medicaid expansion to enhance Insure Oklahoma. This would cover more employees at lower income levels. Incumbent elected officials have refused to accept federal dollars, so this alternative has been discussed as a compromise. Employers have also been reluctant to implement this program for fear that it might be eliminated. I hope our leaders at the state and federal levels will work together to provide this solution for Oklahoma’s working poor.

– Joe Dorman served House District 65 as a state representative for 12 years and was the 2014 Democratic nominee for governor of Oklahoma. Currently he is the Community Outreach Director for Heart Mobile.