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In 2005, the state put in place Insure Oklahoma, which provides subsidies to small businesses that offer employees health care insurance. Small businesses purchase a health plan in the private market and the state reimburses them for 60% or more of the cost; employees pay 15% of the premium. The program started by targeting businesses with 25 or fewer employees and expanded in 2006 to include businesses with up to 50 employees.

The program is funded partially by a state tobacco tax and partially by Medicaid. In order to get Medicaid funding to start the program, the state needed permission from the feds to use Medicaid money for people who aren't typical Medicaid recipients - in this case, small business employees. When the Oklahoma Health Care Authority wanted to expand Insure Oklahoma further, to include larger small businesses, it needed permission again - in the form of a waiver - from the Centers for Medicare and Medicaid Services. Portions of that waiver were approved January 1, after a wait of more than 15 months. Insure Oklahoma can now include businesses with up to 250 employees, said Jo Kilgore, a Health Care Authority spokesperson, but the state plans on increasing slowly. It recently upped the size of qualifying business to those with up to 99 employees.

"Insure Oklahoma was created to help small business, and in keeping with that, we want to ramp it up gradually, because we know the program will cap at 37,000 to 40,000 participants," Kilgore says. Participation in Insure Oklahoma has been increasing by 800 to 1,000 participants a month since its inception; the program currently serves about 11,000 small business employees.

NEXT: South Carolina

LAST UPDATE: Jan 28 2009 | 9:53 AM ET
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