Medicaid Expansion Coming to Oklahoma

[king183]

I decided to start this based on a comment in another thread that indicated some people aren't aware the state is in the process of officially expanding Medicaid (not Medicare, which is the federal health program primarily for people over the age of 65). With the COVID 19 response filling the news, a lot of people are likely unaware.

The Oklahoma Health Care Authority on Friday will submit to the federal government a state plan amendment seeking to expand Medicaid in Oklahoma as soon as this summer.

"The Health Care Authority has the authority to send in the paperwork to expand, and we’re going to get that out on Friday," Gov. Kevin Stitt told The Oklahoman on Thursday.

The state plan amendment will get the ball rolling for Oklahoma to seek federal approval to expand Medicaid.

The expansion will likely become effective in June or July. As a condition of expanding, the state is going to have to pay 10% of the total costs for the newly eligible population, which is expected to be $150 million a year. The legislature has not yet decided how they will fund that obligation, but several options are being considered, including increasing the assessment on hospital revenues, called the Supplemental Hospital Offset Payment Program. This is an assessment hospitals pay to the state, which is in turn used to get matching funding from the federal government. It is intended to keep provider reimbursements higher than they would be absent the assessment.

After expansion is in place, the Stitt Administration intends to make changes to the program. The administration is working with Health Management Associates, a consulting firm out of Michigan with ties to the Trump Administration, to submit a "Healthy Adults Opportunity" waiver application that will enact work/community engagement requirements and require those on the program to pay modest premiums.

Separate from all of this, there will soon be a state question--SQ 802-- before the people to decide whether to make the expansion part of the Oklahoma Constitution and prohibit the legislature or the Health Care Authority from adding any restrictions to the program. Governor Stitt has not yet decided when to place the question on the ballot.

[HangryHippo]

Regardless of personal stance, Stitt needed to get off his ass and set an election. The people want it voted on and it needs to happen.

That being said, coronavirus has certainly thrown a wrench into everything.

[Laramie]

Regardless of personal stance, Stitt needed to get off his ass and set an election. The people want it voted on and it needs to happen.

That being said, coronavirus has certainly thrown a wrench into everything.

Good point Nick, at least allow the people to vote. The expansion will allow for more coverage of Oklahomans throughout the state and save many rural hospitals.

As of Aug. 1, Oklahoma was one of 14 that had not accepted expansion, according to a count from the Kaiser Family Foundation.

Key Facts to Know About Medicaid Expansion Proposal: https://oklahomawatch.org/2019/08/19...sion-proposal/

[king183]

Just to be clear: Medicaid expansion is happening regardless of the vote on SQ 802. The question is whether Medicaid expansion is put in the Oklahoma Constitution or not.

Come July 1, assuming the feds approve it, Oklahoma will have Medicaid expansion.

[emtefury]

Great. More of my tax dollars going towards other people's free stuff.

[Plutonic Panda]

The vote date has been set to June 30th for the ballot version of the expansion:

https://nondoc.com/2020/04/17/sq-802...aid-expansion/

[TheTravellers]

The vote date has been set to June 30th for the ballot version of the expansion:

https://nondoc.com/2020/04/17/sq-802...aid-expansion/

About time. Although his SoonerCare 2.0 thing could mess with it, I need to read more about how both of those will interact if the SQ passes and SoonerCare 2.0 goes into effect. I'll be voting in person for this one, most likely, because absentee voting in OK requires a notarization of the ballot, so if you do it, you *still* have to interact with somebody in person.

[Plutonic Panda]

I’m interested in how the sooner care 2.0 will interact with this as well.

[king183]

Interact how? I can probably answer that for you. The SQ would effectively prevent many of the provisions of the SoonerCare 2.0, such as the community engagement requirements and the nominal copayments/premiums.

I personally think the SQ is ill-advised because it will either prevent or make extremely difficult the enactment of future innovative solutions, such as a variety of value-based payment arrangements.

The expansion will happen without the SQ passing. And, candidly, the courts will strike down the governor’s proposed community engagement requirements, so I don’t see any benefit to hamstringing future efforts to innovate on the program through a constitutional amendment.

[Bits_Of_Real_Panther]

I'm in favor of reducing the number of people in this state who have no health insurance.

I'll have to figure out how to get my absentee ballot notarized.

[king183]

I'm in favor of reducing the number of people in this state who have no health insurance.

I'll have to figure out how to get my absentee ballot notarized.

I know I’ve written this before on here, but it is worth repeating because there are so many moving parts to this and it’s difficult for people to keep up: the expansion of Medicaid to uninsured, childless adults is going to happen on July 1, whether the SQ passes or fails. You don’t need to vote to expand Medicaid. The vote is, for all intents and purposes, whether to put Medicaid expansion in the constitution and to restrict the ability of the Oklahoma Health Care Authority from make certain changes to the program over time.

[Edmond Hausfrau]

I'm in favor of reducing the number of people in this state who have no health insurance.

I'll have to figure out how to get my absentee ballot notarized.

Next we should vote on removing the notary requirement. Now is the right time to drop it and move to true "vote by mail." It would also be a boon to the rural Oklahoma communities where people don't live "in town".

[Edmond Hausfrau]

Great. More of my tax dollars going towards other people's free stuff.

Isn't that how taxes work?

[TheTravellers]

Next we should vote on removing the notary requirement. Now is the right time to drop it and move to true "vote by mail." It would also be a boon to the rural Oklahoma communities where people don't live "in town".

Absolutely, but I don't think we can get that done this year, wouldn't it have to be the legislature that does it? And they're pretty much done for this session (my Rep told me that all they're going to do is get the budget done and they're outta there). Or can the state Election Board do it unilaterally?

[Bunty]

Great. More of my tax dollars going towards other people's free stuff.

Then bet on SQ 802 being voted down if opponents talk like the only way to pay for it is by raising the state sales tax by .5 or whatever. Or by some other form of tax hike, such as on gas. The former, I think, would be less acceptable. The Medicaid plan that Gov. Stitt has come up with will be regarded as better than nothing, especially if no tax hike is required to pay for it.

[David]

Given the enthusiasm for signatures on the petition, I'm not sure I'd count on it being voted down. The current virus situation may have an impact on the June 30th election date, but who knows which direction that impact would lean.

[Edmond Hausfrau]

Is there any reason we can't take the federal Medicaid expansion, drop Stitt's 2.0 "community engagement" work requirements, and not add something onerous to the Oklahoma Administrative Code that 30 years from now will read as ridiculously as the old state liquor laws once read?

[TheTravellers]

Is there any reason we can't take the federal Medicaid expansion, drop Stitt's 2.0 "community engagement" work requirements, and not add something onerous to the Oklahoma Administrative Code that 30 years from now will read as ridiculously as the old state liquor laws once read?

Would be nice, but probably won't happen because...Stitt.

[jerrywall]

Interact how? I can probably answer that for you. The SQ would effectively prevent many of the provisions of the SoonerCare 2.0, such as the community engagement requirements and the nominal copayments/premiums.

I personally think the SQ is ill-advised because it will either prevent or make extremely difficult the enactment of future innovative solutions, such as a variety of value-based payment arrangements.

The expansion will happen without the SQ passing. And, candidly, the courts will strike down the governor’s proposed community engagement requirements, so I don’t see any benefit to hamstringing future efforts to innovate on the program through a constitutional amendment.

This and the fact that the SQ doesn't address (that I could find) the funding issue at all, so we might as well be voting on free unicorns, is why I'll be voting no.

[HangryHippo]

Would a yes vote actually prohibit the brain trust at 23rd and Lincoln from doing anything to modify what that yes vote would put in place? Or would it just make it more difficult to change?

[Jersey Boss]

Then bet on SQ 802 being voted down if opponents talk like the only way to pay for it is by raising the state sales tax by .5 or whatever. Or by some other form of tax hike, such as on gas. The former, I think, would be less acceptable. The Medicaid plan that Gov. Stitt has come up with will be regarded as better than nothing, especially if no tax hike is required to pay for it.

I don't see a tax hike doable with the 75% requirement. More likely will be a reduction somewhere. Closing some CC campuses or some other such method of cuts. Maybe sell off some of the real estate the state holds?

[Jersey Boss]

This SQ is a result of the legislature giving a chorus of no in the past, over the objections of the Governor at the time. The legislature has had more than enough time to have crafted a bill that would have not made the SQ such a popular option.

[Edmond Hausfrau]

Maybe it's time to consider redrawing some legislative districts to get more diversity of thought in the Capitol.

[Bunty]

Maybe it's time to consider redrawing some legislative districts to get more diversity of thought in the Capitol.

Why? Are rural districts acting like they're not as much concerned as they should be about the future of their medical care? If so, I'm not sure urban districts would be very sympathetic about the needs of the rural districts.

[Edmond Hausfrau]

Absolutely, but I don't think we can get that done this year, wouldn't it have to be the legislature that does it? And they're pretty much done for this session (my Rep told me that all they're going to do is get the budget done and they're outta there). Or can the state Election Board do it unilaterally?

Or we can just see how this lawsuit plays out. I had no idea that only 3 states in the union require a notary, and we are one of the unfortunate 3.
Since the suit names the Secretary of Election Board, I am supposing that is who has the ability to change the rule?
https://www.tulsaworld.com/news/stat...HFlMEzO2eMRAWU