Geographic location is a factor, too. Under Obamacare, Oklahoma has been divided into five regions. Insurers are allowed to charge different rates in different regions based on their claim histories and projected costs.
Aetna’s lowest rates will be offered in the Oklahoma City metro area. Rates are 5 percent higher in Le Flore and Sequoyah counties, 13 percent higher in the seven-county Tulsa metro area, 34 percent higher in Comanche County and 23 percent higher in the rest of the state. Other companies have different geographic rate formulas.
In most cases, marketplace customers will wind up paying considerably less than the companies’ policy rates because they will receive federal tax credits to offset the cost. The amount of the credits will vary, depending mainly on income, and will be calculated on a person-by-person basis.
The tax credits will be available to individuals with incomes between $11,490 and $45,960 a year, and four-person families between $23,440 and $94,200. People with higher incomes can purchase insurance in the federal marketplace, but they will pay the full posted rate for their plans.
Oklahomans with lower incomes below 100 percent of the federal poverty level are not eligible to receive subsidized plans through the marketplace because the Affordable Care Act originally contained a nationwide expansion of Medicaid to cover everyone below the poverty line.
That provision of the law was struck down by the U.S. Supreme Court. Oklahoma declined to expand its Medicaid program voluntarily. As a result, as many as 150,000 uninsured Oklahomans are expected to remain stuck in a coverage crater, ineligible for either subsidized program.
About 337,000 uninsured Oklahomans will be eligible to participate in the health care marketplace and receive federal tax subsidies, according to one recent study. The marketplace is open to anyone who can’t participate in an affordable employer-provided plan and who doesn’t qualify for other forms of public insurance such as Medicare.