Oklahoma Releases Draft 1332 State Innovation Waiver for Public Comment

The Oklahoma Insurance Department released a draft ACA Section 1332 State Innovation Waiver for public comment on October 8, 2026, with plans to submit the application to the federal government in fall 2026. The waiver seeks federal approval to implement a reinsurance program in Oklahoma's individual health insurance market, with a proposed effective date of January 1, 2028. The reinsurance program is designed to address instability in Oklahoma's individual market, which the Department characterizes as experiencing declining enrollment, high premiums, and limited insurer participation. The stated goals of the waiver are to improve affordability, increase competition, and expand access to coverage, particularly in high-cost regions with limited issuer participation. The Department projects the reinsurance program would reduce premiums between 4.1% and 6.4% statewide, with reductions of up to 14.6% in high-cost regions of the state. The waiver framework allows Oklahoma to tailor market stabilization mechanisms to state-specific conditions rather than relying on standard federal program structures. The public comment period runs through October 31, 2026, with written comments accepted by email at 1332waiver@oid.ok.gov or by mail to the Oklahoma Insurance Department. The Department is hosting two public hearings on October 13 and October 14, 2026, and a separate hearing for members of Oklahoma Tribal Nations on October 22, 2026, all at the Oklahoma Health Care Authority in Oklahoma City.