Health insurance exchanges and the expansion of Medicaid are major components of the Affordable Care Act, aka Obama care. 

With exchanges, consumers will be able to compare health plans and select the one that's best for them. 

Plus, consumers who are eligible will receive a tax credit for the purchase of care. 

States have been given the chance to develop their own state-based exchanges. 

The Oklahoma Policy Institute's David Blatt says the Federal government will step in if Oklahoma is unwilling to ‘play ball’: “In Oklahoma’s case we’ve made no progress and done nothing to implement one.  If we continue to not move ahead with an exchange then we will have a federally-facilitated exchange.” 

Blatt says a federal exchange should serve consumers well, but it leaves decision making authority in the hands of Washington rather than Oklahoma.

The state has until November to submit a blue print for a how it would develop a plan. 

If that doesn't happen the federal government will proceed to develop the exchange that will operate in Oklahoma.  

Regarding Medicaid, Blatt says not expanding it “lacks economic sense, common sense and basic compassion.”

Blatt says if Oklahoma does go ahead and expand Medicaid the federal government would cover between 90 and 95 percent of costs over the initial period of the expansion.

Not expanding Medicaid would create a huge coverage crater: "We are looking at 200,000 or more low-income Oklahomans who generally are not offered health insurance or can't afford it who would be left without coverage."