俄克拉荷马州发布医保1332豁免草案：拟设再保险计划，2028年起保费最高降14.6%
俄克拉荷马州俄克拉荷马城市讯——俄克拉荷马州保险厅 10 月 8 日发布《平价医疗法案》（ACA）第 1332 条"州创新豁免"草案，向公众征求意见。这是该州设立再保险计划、从 2028 年 1 月 1 日起降低个人医保市场保费的第一步。
保险厅计划今年秋季向联邦政府正式提交豁免申请。草案预计，再保险计划可使全州个人医保保费下降 4.1% 至 6.4%，在保险公司少、成本高的地区降幅最高可达 14.6%。
"提交俄克拉荷马州的 1332 豁免申请，是让本州家庭医保更负担得起的重要一步，"保险厅厅长格伦·穆尔里迪（Glen Mulready）说，"俄克拉荷马人持续感受到医疗费用上涨的压力，我们有责任用好每一个负责任的工具把保费降下来。这项豁免让俄克拉荷马有机会量身打造适合本州的方案，而不是套用一刀切的办法。我们的目标很明确：让个人市场更稳定、让消费者花得更少、让俄克拉荷马的医保市场更强壮、更可持续。"
背景是多年来的市场动荡。自平价医疗法案实施以来，俄克拉荷马州个人医保市场一直不稳定：参保人数下滑、保费高企、参与的保险公司少，偏远和高成本地区的居民受影响最大，有的地方几乎无险可选。
ACA 第 1332 条允许各州在满足联邦关于覆盖面、可负担性、保障全面性和联邦支出四条底线的前提下，向联邦申请试行替代方案。再保险——即由州政府帮助保险公司分担最贵参保人的费用——是最常见的豁免用途之一，已有多个州借此成功压低了保费。
目前草案正公开征求意见。书面意见受理至 2026 年 10 月 31 日，可发邮件至 [email protected]，或邮寄至：Oklahoma Insurance Department, Attn: State Based Exchange / 1332 Waiver, 400 NE 50th Street, Oklahoma City, OK 73105。
州政府还将在俄克拉荷马市的州医保局（Oklahoma Health Care Authority，4345 N. Lincoln Blvd.）举行三场听证会，均提供线上参加方式：10 月 13 日下午 2 点（中部时间）第一场公众听证、10 月 14 日上午 11 点第二场，以及 10 月 22 日上午 10 点专门面向俄克拉荷马州部落民族成员的听证。报名信息见保险厅官网。
若按州政府的时间表获批，再保险计划将在 2028 参保年度生效——意味着一年多以后，购买个人医保的俄克拉荷马家庭就能在保费账单上看到实惠。
Oklahoma Releases Draft ACA Section 1332 Waiver; Reinsurance Plan Could Cut Premiums Up to 14.6% From 2028
OKLAHOMA CITY — The Oklahoma Insurance Department on October 8 released a draft Affordable Care Act Section 1332 State Innovation Waiver for public review and comment, the first step toward a state-run reinsurance program aimed at lowering health insurance premiums in the individual market starting January 1, 2028.
The department intends to submit the waiver application to the federal government this fall. According to the draft, the reinsurance program is projected to reduce premiums between 4.1% and 6.4% statewide, with reductions of up to 14.6% in high-cost regions of the state where few insurers participate.
"Submitting Oklahoma's 1332 waiver application is an important step toward making health insurance more affordable for Oklahoma families," said Insurance Commissioner Glen Mulready. "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 backdrop is years of instability. Since the Affordable Care Act took effect, Oklahoma's individual health insurance market has struggled with declining enrollment, high premiums, and limited insurance company participation — problems that have hit rural and high-cost regions especially hard, leaving some residents with few or no choices of insurers.
Section 1332 of the Affordable Care Act allows states to seek federal approval to try alternative approaches to certain federal health insurance requirements, as long as they meet federal guardrails on coverage, affordability, comprehensiveness, and federal spending. Reinsurance — in which the state helps insurers cover the costs of their most expensive enrollees — is one of the most common uses of the waiver, and multiple states have used it to bring premiums down.
Oklahoma is now asking the public to weigh in. Written comments on the draft waiver are being accepted through October 31, 2026, by email at [email protected] or by mail to the Oklahoma Insurance Department, Attn: State Based Exchange / 1332 Waiver, 400 NE 50th Street, Oklahoma City, OK 73105.
The state will also hold three public hearings at the Oklahoma Health Care Authority, 4345 N. Lincoln Blvd. in Oklahoma City, with virtual attendance options: Public Hearing #1 on October 13 at 2:00 p.m. CT, Public Hearing #2 on October 14 at 11:00 a.m. CT, and a hearing for members of Oklahoma's Tribal Nations on October 22 at 10:00 a.m. CT. Registration information is available on the Insurance Department's website.
If the waiver is approved on the state's timeline, the reinsurance program would take effect for the 2028 plan year — meaning Oklahoma families shopping for individual coverage could see relief in the premiums they pay starting in just over a year.
图片来源：CC0（Wikimedia Commons，Oklahoma Legislative Services Bureau）
