7,000 Oklahomans Got Their DPC Doctor Through an Insurer. Now the State Runs the Insurer.
On Oct. 29, Oklahoma's insurance commissioner took control of Mending Health Insurance in Oklahoma. The order is called a conservatorship. A state-appointed conservator now runs the company's day-to-day business and goes through its books, "due to the precarious financial standing of the company," in the department's words. The department didn't release a single financial figure.
Mending was an unusual insurer. It sold Marketplace plans built around direct primary care. Its Oklahoma page advertised unlimited $0 primary care visits, and members could join a DPC doctor for $0. About 7,000 Oklahomans were affected when Mending announced in June that it was leaving the market, KGOU reported at the time.
I like the instinct behind that product. Put a real doctor at the front of the plan, take the copay out of the exam room, and let the insurance handle the big things. That's close to what many of us have been arguing for years.
But look at what happened to the doctor part.
Mending filed notice on June 25 that it would leave the Oklahoma marketplace on Dec. 31. In July the state put a supervisor beside management. In late October the state took the wheel. The official instructions to members fit in two sentences: your policy stays in effect for now, and keep paying your premiums. The instruction to doctors was to keep seeing Mending members and not to charge them anything beyond their normal cost share. None of that is the patient's choice or the doctor's. It's a regulator's.
The patients didn't do anything wrong. Neither did their doctors. They signed up for a relationship, and the relationship was riding on someone else's balance sheet.
There is a replacement lined up. CommunityCare, owned by Saint Francis Health System and Ascension St. John, posted six 2027 Marketplace plans with in-network DPC doctors, according to DPC Insider. The three "$0 PCP" designs look a lot like Mending's: deductibles of $5,000 for bronze, $2,500 for silver, and $0 for gold. Read the fine print, though. Out-of-pocket maximums run $10,000 to $12,000. On the $0-deductible gold plan, the emergency room and an inpatient stay carry 50% coinsurance. Only 1 of the 6 is HSA-qualified, with a $7,500 deductible and a $50 primary care copay. And you have to live in a covered county.
So a patient who wants to keep the same doctor in January has to check the network, check the county list, check the plan design, and hope the practice signed with the new carrier. That's four tests for a relationship that used to need one handshake.
This is the part of direct care that gets lost when it's bolted onto an insurance card. The whole point of the model is that the agreement belongs to the patient and the doctor. A flat monthly fee. Cancel any month. No claim to file, no network to stay inside, no carrier whose finances decide whether your doctor is still your doctor next year. When the membership rides inside a policy, it inherits every weakness of the policy: the annual reshuffle, the county map, the solvency of a company most patients have never heard of.
Insurance is a fine tool for what insurance is good at, pooling the rare, enormous bill. A gold plan that leaves you with half of a hospital stay has that backward. The cheap, frequent, personal part of medicine, the sore throat and the blood pressure and the text at 9 p.m., doesn't need pooling. It needs a doctor you pay directly and can keep.
If you are one of Mending's members, the Marketplace deadline for a Jan. 1 start is Dec. 15. Before you pick a plan, call your doctor. Ask whether the practice will be in network next year, and ask the better question too: can I just pay you directly? Many DPC practices will say yes, at a monthly price they post on the first page of their website. Then buy the insurance you need for the hospital, and keep the doctor no matter which insurer is standing next year.
Sources: Oklahoma Insurance Department, "Commissioner Mulready Places Mending Health in Conservatorship" (Oct. 30, 2026): www.oid.ok.gov/release_103026/ ; DPC Insider, "Oklahoma Takes Over Mending's Insurer Days Before Open Enrollment" (Nov. 3, 2026): www.dpcinsider.com/blog/2026-11-03-mending-conservatorship-oklahoma-communitycare-dpc-plans/
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