Attacks on Private Health Insurance Will Cost Families and Businesses

By Oklahoma Families for Affordable Health Care Executive Director Ericka McPherson

It is a common refrain at the Oklahoma State Capitol that lawmakers should pursue free-market solutions, avoid costly government mandates, and not support special interests over the best interests of all Oklahomans. Where health care policy is concerned, many lawmakers were elected on explicit promises to oppose and repeal Obamacare and other Big Government health care policies. In this context, it is puzzling to see so many lawmakers working to actively dismantle the alternative to Obamacare, which is employer-sponsored health insurance, of which many Oklahomans rely upon to manage their health care costs.

 Employer sponsored health insurance relies on the ability to contract with third party vendors to offer health benefit coverage and other benefits. Those vendors – called health plans – then negotiate with health care providers to offer services at agreed upon price points, thereby lowering, and allowing for the management of such costs. When you go to a provider that is “in network,” they have agreed to honor the pricing expectations of one’s health plan. Similarly, employers also encourage their employees to utilize pharmacies that sell prescription drugs at lower prices or may incentivize the use of lower cost options like mail order.

 Health plan networks are the primary tools used in the private sector to make health care more affordable. This longstanding health care model is being systematically dismantled by legislators responding to calls from special interest groups, in direct opposition to the health care cost concerns expressed by Oklahoma families, businesses, and consumers.

 For instance, House Bill 3023 will dismantle privately agreed upon contracts that establish cost savings networks of dentists. These dentists join a network of preferred providers in exchange for agreeing to serve various businesses’ employees and their families at an agreed upon price. The establishment of these networks provides accountability and transparency for all parties involved, but most importantly protects the budgets of both families and businesses. At the behest of dentists who are either not currently in a network, or perhaps in-network and want to charge their patients more, lawmakers are considering dismantling these contractual consumer safeguards. Should HB 3023 become law, it will ultimately result in Oklahoma patients paying tens of millions of dollars more in dental bills every year. 

 SB 1860, along with a suite of similar bills, functions in much the same way for pharmacies. It dismantles cost protections for consumers and forces employers to treat a pharmacy that sells a pill for $4 the same way as a pharmacy selling the same pill for $2. SB 1860 will end incentives for employers to encourage convenient and less costly mail order drug delivery, even though studies show it is medically beneficial to patients, who are more likely to take drugs that are delivered directly to them on a regular schedule. SB 1860 and other similar measures benefit some pharmacists at the ultimate expense of patients, families, and employers.

 Oklahomans should be disturbed by this trend in healthcare policy for many reasons. These bills will drive up the cost of health care for families, patients, and employers.  Individuals’ health will decline as they forgo care due to increasing costs. Families will suffer economically at a time when inflation and other world events are already hurting their bottom line. Businesses will have to choose between fewer health care benefits or layoffs. This current trend in health care policy by lawmakers is unhealthy and costly for Oklahomans.

 It used to be taken for granted that lawmakers were trying to reduce health care costs for the population at-large; to do otherwise would be unfathomable. Now, however, lawmakers are openly pushing legislation that enriches a few special interests at the expense of all Oklahomans. If something does not change quickly, Oklahomans will be less healthy and prosperous.