On March 4, 2016, the Oklahoma Health Care Authority formally submitted to the federal Centers for Medicare and Medicaid Services a request to amend its section 1115 waiver to incorporate the Insure Oklahoma Sponsor’s Choice Option, which would allow Indian Health Service (IHS), Tribal, and urban Indian organization health care facilities (I/T/Us) to sponsor eligible individuals by paying their premiums for health insurance coverage through Insure Oklahoma. On behalf of the Tribal Self-Governance Advisory Committee (TSGAC) of IHS, these comments were submitted to express strong support for approval of this request, as it would help address the needs of a severely underfunded Indian health care system in Oklahoma.