OKLAHOMA CITY (KFOR) – An Oklahoma state leader says the Sooner State will become one of the first in the nation to leverage the Trump administration’s new policy on Medicaid.
On Thursday, Oklahoma Gov. Kevin Stitt was in Washington to announce his new plan for Medicaid in the state.
“I have sought Oklahomans’ input in crafting my administration’s healthcare plan. They have told me that they want more access to care in rural Oklahoma; they want us to address wait times for basic healthcare services for our most vulnerable populations; and they want better care, quality care – not excessive care.
I am also here today, because Oklahomans want their federal tax dollars to be returned to the state and put to work. But efforts to do this through amending our Constitution to force Medicaid Expansion are wrong and will be ineffective and will fail to fix our problems,” Stitt said.
In recent years, there has been a push across the state to expand Medicaid.
Since the Affordable Care Act was passed in 2014, Oklahoma has rejected federal money for Medicaid expansion. A bill that would expand Medicaid coverage in the state died in the Legislature last session.
”Right now, the fact that we’re not accepting Medicaid expansion, we’re turning away over a billion dollars a year annually,” Yes on 802 Campaign Manager Amber England said.
In October, volunteers with ‘Yes on 802’ turned in thousands of signatures in order to get State Question 802, which would expand Medicaid, on the ballot. The group needed 178,000 signatures to move their petition forward.
In the end, the group broke a state record for turning in the most signatures in state history with 313,000. After being analyzed by the Secretary of State’s office, the agency verified 300,000 signatures.
Opponents of that move say the cost of expanding Medicaid is simply too expensive.
"Any state that does Medicaid expansion is responsible for 10 percent of the costs, whatever they are," Jonathan Small, President of the Oklahoma Council of Public Affairs, said.
The federal government pays the other 90 percent of the expansion.
On Thursday, the Trump administration announced the “Healthy Adult Opportunity,” which permits states to apply for so-called block grants to cover certain low-income adults, particularly those who gained benefits under the Affordable Care Act’s Medicaid expansion provision. Federal funding, which is now open-ended, would be capped, with states receiving either a lump sum or a specific amount per enrollee.
The newly issued guidance is targeted at working age, able-bodied adults and does not apply to most of Medicaid’s traditional beneficiaries, including children, seniors or the disabled. However, states that did not expand Medicaid could apply for fixed funding to cover certain low-income adults in their programs.
Also, states that opt to receive a set annual amount could keep a portion of any unused funds, though they must show that access to and quality of care has not declined and they must reinvest that money into the Medicaid program. And they could request to add new conditions for eligibility for these recipients, change their benefits, require them to pay more and limit their drug coverage by implementing a list of approved medications.
Among the main concerns about block grant funding is that the lump sum model cannot adjust to economic downturns, when enrollment typically increases, and that both the fixed annual amount and the per person cap versions would have difficulty handling spikes in health care treatment costs.
The agency could work with states to readjust the funding levels under those circumstances, officials said.
"When I return home, the Oklahoma Health Care Authority will begin taking next steps on implementing SoonerCare 2.0 by applying for additional federal funds and the HAO flexibility waivers.
We will be seeking flexibility through HAO in order to innovate the delivery of services in the following ways:
We will achieve cost containment by changing our Medicaid system to focus on rewarding health outcomes and stronger performance in care. We will navigate away from the government-run, fee-for-service model that 40 other states have already abandoned, and we will focus this reform first on those that will become eligible under SoonerCare 2.0.
We will seek approval under HAO to push the limit of innovation and set up a program that creates expectations for able-bodied individuals to see this as a true trampoline to their future.
With flexibility, we will seek to establish moderate premiums to prepare members for the responsibility of transitioning to private health insurance coverage.
With flexibility, we will seek to establish work requirements that encourage Oklahomans to be engaged in activity that advances their personal potential – whether it be education, certification programs, work, or community involvement.
With flexibility, we seek to establish programs that better address Oklahoma’s unique rural needs, such as enhancing provider reimbursement, authorizing telehealth services, and reimagining “hospitals” to expand care options in areas with limited populations.
And with flexibility, we will seek to expand targeted treatment for opioid addiction and substance abuse. Oklahoma is in the midst of establishing a world-class research institution on opioid addiction. With HAO flexibility, we will be able to more quickly support our communities and implement lessons we are learning and discovering," Stitt said.
The Stitt administration will seek partnership with the Legislature to support the State’s share by:
- Recognizing cost savings in Department of Corrections and Department of Mental Health and Substance Abuse, where millions of dollars currently being paid 100% by the State will be replaced with federal funding once SoonerCare 2.0 is fully implemented.
- Leveraging the full Supplemental Hospital Offset Payment Program (SHOPP) fee of 4% currently in state statue, a rate in Oklahoma that will remain below the national standard of 6%.
- Requesting Oklahomans to reform TSET, protecting the corpus and leveraging future funds to directly deliver stronger, more accessible healthcare services to rural Oklahoma as part of SoonerCare 2.0.