OKLAHOMA CITY, Okla. — The Oklahoma Insurance Department has released a draft Affordable Care Act (ACA) Section 1332 State Innovation Waiver for public review, outlining a proposed reinsurance program designed to reduce health insurance premiums, strengthen market competition and improve access to affordable coverage across the state.
The department plans to submit its waiver application to the federal government in fall 2026, seeking approval to launch the program on January 1, 2028. If approved, the initiative would target Oklahoma’s individual health insurance market, where rising costs and limited insurer participation have created challenges for consumers.
Oklahoma Proposes Reinsurance Program to Address Rising Health Insurance Costs
Oklahoma’s individual health insurance market has faced significant instability since the implementation of the Affordable Care Act. Declining enrollment, elevated premiums and limited participation from insurance companies have continued to affect the availability and affordability of coverage.
The proposed Section 1332 waiver would allow Oklahoma to introduce a state-specific reinsurance program intended to stabilize the market and reduce costs for consumers purchasing individual health insurance policies.
Reinsurance programs generally help insurance companies manage the financial risks associated with high-cost medical claims. By offsetting a portion of these expenses, such programs can reduce pressure on insurers to increase premiums.
State officials believe this approach could encourage additional insurance companies to participate in Oklahoma’s individual market while providing more affordable coverage options for residents.
Projected Premium Reductions Range From 4.1% to 14.6%
According to projections included in the state’s proposal, the reinsurance program could reduce individual health insurance premiums by approximately 4.1% to 6.4% statewide.
Residents in certain high-cost regions could experience more substantial reductions, with projected premium decreases reaching as much as 14.6%.
These estimates represent anticipated effects of the proposed program rather than guaranteed savings. Actual premium changes would depend on federal approval, implementation details and market conditions when the program begins.
The department has identified regions with higher insurance costs and limited insurer participation as particularly important areas for potential improvement.
By reducing financial risks for participating insurers, the state hopes to improve competition and expand access to health insurance coverage.
Insurance Commissioner Highlights Need for State-Specific Solutions
Oklahoma Insurance Commissioner Glen Mulready emphasized the importance of addressing rising health care expenses through policies designed around the state’s insurance market.
“Submitting Oklahoma’s 1332 waiver application is an important step toward making health insurance more affordable for Oklahoma families,” Insurance Commissioner Glen Mulready said. “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 proposal reflects Oklahoma’s effort to use flexibility available under federal health insurance law to address challenges within its individual insurance marketplace.
How Section 1332 Waivers Work Under the Affordable Care Act
Section 1332 of the Affordable Care Act allows states to request federal approval for alternative approaches to certain health insurance requirements.
These waivers give states flexibility to develop programs suited to local market conditions while meeting federal standards related to coverage, affordability, comprehensiveness and federal spending.
Reinsurance is one approach states can pursue through this process to help stabilize individual insurance markets.
For Oklahoma, the proposed waiver would establish a framework for reducing premiums while supporting a more competitive and sustainable insurance marketplace.
Public Comment Period Open Through October 31, 2026
The Oklahoma Insurance Department is accepting written public comments on the draft waiver through October 31, 2026.
Residents, insurance companies, health care organizations and other interested stakeholders can review the proposal and submit feedback before the state proceeds with its planned federal application.
Comments may be submitted by email to [email protected].
Written comments may also be mailed to the Oklahoma Insurance Department and must be received by October 31, 2026.
Additional information about the proposed waiver and Oklahoma’s health insurance marketplace is available through the department’s official website.
Proposed Program Would Begin January 1, 2028
The state intends to submit its Section 1332 waiver application to federal officials during fall 2026, with implementation scheduled for January 1, 2028, subject to approval.
The public comment process provides an opportunity for stakeholders to evaluate the proposal and its projected effects on insurance premiums and market participation.
If approved and implemented as planned, Oklahoma’s reinsurance initiative could help reduce individual health insurance costs, encourage insurer participation and improve long-term market stability. The outcome will depend on federal authorization and the program’s effectiveness in addressing the state’s affordability challenges.
