On February 25, Oklahoma leaders announced our state would accept a $54.6 million “Early Innovator” grant from the U.S. Department of Health and Human Services (HHS). The “Early Innovator” grants were authorized under the Patient Protection and Affordable Care Act to begin developing the information technology (IT) infrastructure for the “health benefits exchanges” as required under the Act.

That decision has sparked much discussion and confusion regarding health insurance exchanges and the use of the federal grant to implement an exchange in Oklahoma. To their credit, Oklahoma’s leaders have, to date, been clear that their intention is to take the federal funds and create a health insurance exchange that empowers consumer choice through real competition—in essence, an exchange unlike those required under the Affordable Care Act.

However, a serious question remains: Does the “Early Innovator” grant permit Oklahoma to use this $54 million to create the type of “patient-centered,” “free-market, conservative” insurance exchange state leaders are pursuing?