Oklahoma Health Care Authority Proposes Plan To Insure More Oklahomans

Mar 31, 2016

Nico Gomez, CEO of the Oklahoma Health Care Authority.
Credit Warren Vieth / Oklahoma Watch

A new plan from Oklahoma’s Medicaid agency would provide coverage for uninsured Oklahomans, and would tap into federal matching funds.

Oklahoma Health Care Authority CEO Nico Gomez addressed Gov. Mary Fallin and legislative leaders on Thursday to present the three-part “Medicaid Rebalancing Act of 2020.”

“We came up with a plan that does not expand Medicaid, but actually puts 350,000 people into the commercial healthcare market over a four year period so it really starts to stabilize by reducing the number of uninsured by 35 percent,” Gomez said.

Under the new plan, Insure Oklahoma would become available for 175,000 adults between 19 and 64 years of age who are below 133 percent of the federal poverty level. Participants would pay a premium on a sliding scale, and would receive personal financial incentives for healthy behaviors.

Currently, Insure Oklahoma is available to small businesses to assist them in paying premiums for their employees’ insurance.

The plan would also move 175,000 SoonerCare recipients who are pregnant or children to the private health insurance market, where they would receive tax credits to help cover premium costs. Gomez estimates this move would save the state nearly $60 million.

The third part of the plan would restore the Medicaid reimbursement rate to 86.5 percent of Medicare. Earlier this week, the Oklahoma Health Care Authority proposed reducing the reimbursement rate to providers by 25 percent as a result of the estimated $1.3 billion general revenue shortfall in the upcoming fiscal year.

Gomez expects the Insure Oklahoma part of his plan would cost approximately $1 billion over four years to implement. The federal government would pay 90 percent of those costs, while the state would kick in $100 million.

“We’re creating a program that attracts a 90 percent match rate, basically getting 90 percent of our federal tax dollars back and spending them in a way that really reflects Oklahoma values, that protects human dignity, and that really emphasizes personal responsibility,” Gomez said.

Gomez suggested several financing options, including a $1.50 tax per pack of cigarettes.

In a written statement, Oklahoma Policy Institute executive director David Blatt called the plan to accept federal funds to expand health coverage "great news."

"While this is a great first step, the details of the plan should be examined carefully," Blatt wrote. "We must ensure that those who enroll in the program have access to affordable and comprehensive health care. We must also make it our highest priority to avert huge cuts to health services and provider rates proposed by the Health Care Authority, Mental Health Department, and other agencies to cope with the state's budget crisis. These cuts threaten to decimate our health care system and to deprive hundreds of thousands of Oklahomans of needed care. A well-designed plan to accept federal funds will be a key piece to preventing this disaster."

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