Still, Oklahoma officials aren't ready to pull the trigger on a definite appeal of the waiver denial. 'Any determination to appeal will be based on a thorough analysis by the Oklahoma Insurance Department of the rationale behind the denial,' Glenn Craven, spokesperson for the department told HealthLeadersMedia in an e-mail exchange. 'We would need to find new evidence or make additional points to bolster our case, not just insist that HHS got it wrong.'
Sandy Praeger, the Kansas insurance commissioner, voiced similar concerns regarding a possible appeal. 'As we've looked at 2011 data, it looks like insurers are making adjustments and getting close to the 80/20 requirement.' In a telephone interview she explained that the state's primary concern is to protect the individual market. 'It's not huge, but everyone [insurers] is important and we don't want anyone to leave.'
Only 17 states and Guam filed MLR waiver requests and CMS has acted on all but three: North Carolina, Texas, and Wisconsin. CMS has granted six waivers: Georgia, Iowa, Kentucky, Maine, New Hampshire, and Nevada.
It denied a waiver for Guam and eight states: Delaware, Florida, Indiana, Kansas, Louisiana, Michigan, Oklahoma, and North Dakota.