, Muskogee, OK

Oklahoma News

April 21, 2013

Delay likely for health care expansion plan

— OKLAHOMA CITY (AP) — A plan to provide health coverage to 200,000 uninsured, working-class Oklahomans without expanding Medicaid likely won’t materialize before this year’s legislative session ends and it still isn’t clear how any plan might work.

Gov. Mary Fallin and the Oklahoma Health Care Authority have been seeking ways to extend health coverage to those Oklahomans since shortly after Fallin rejected the Affordable Care Act’s Medicaid expansion in November. The authority approved a $500,000 contract with Leavitt Partners to look into the matter in January, hoping a plan could be constructed before the legislative session ends in May.

Authority spokeswoman Sasha Bradley said Friday that the Utah company’s final report isn’t expected until late June, however, with only preliminary reports available before state legislators return home for the summer, dashing hopes of giving a proposal to the governor this year.

“I hate to hear that, because I was hoping, if they’d released their plan and it suggested we have an Oklahoma plan, that it’d be ready to go,” said Rep. Doug Cox, R-Grove, a physician who is the chairman of the House appropriations subcommittee for public health and social services. He said he and several other officials had kept a bill ready to carry the recommendations. “It’s not like it’s the end of the world, because really the ACA doesn’t kick in until 2014. But the more time we have to get an Oklahoma plan before that date the better,” he said.

After the Supreme Court upheld most of the nation’s new health care law last summer, red-state governors across the country, including Fallin, found themselves stuck between hundreds of thousands of working-class, low-income voters who can’t afford health insurance and the political peril of accepting funding to expand Medicaid and provide coverage to them. The federal law allows states to extend Medicaid benefits to people who make less than 138 percent of the federal poverty line, which comes to about $31,000 for a family of four.

Leavitt Partners hasn’t said what its recommendations may be.

Several Oklahoma officials said Friday that the plan could draw from a proposal in Arkansas, where Gov. Mike Beebe, a Democrat, and a Republican legislature united last week around a plan to use the extra Medicaid funding to purchase private insurance for the newly Medicaid-eligible population. The federal Department of Health and Human Services, which oversees the health care law, has given tentative approval to the concept behind the Arkansas plan, sparking wide interest.

“We just know because they’re in a similar position,” Bradley said. “I definitely think that’ll impact (the report), but we definitely don’t know anything for sure.”

Florida, Indiana and other states are also considering plans to funnel federal funding into private insurance plans. The practice, called premium assistance, is allowed under federal law, but states used it to help provide coverage for only about 130,000 people nationwide in 2010, according to a report from the U.S. Government Accountability Office.

Such a plan could potentially build off of Insure Oklahoma, a program that uses Medicaid funds to help cover low-income Oklahomans who wouldn’t otherwise qualify for Medicaid with private insurance. The program provides coverage to about 30,000 Oklahomans and is sustained by a federal waiver that ends after this year.

“We certainly encourage them to look very seriously at an option that would either be an expansion of Insure Oklahoma or something along the same lines,” said Craig Jones, the president of the Oklahoma Hospital Association. “The state’s ability to expand coverage for the uninsured is definitely going to require some level of additional assistance from the federal government.”

Fallin’s spokesman Alex Weintz declined to say what kind of plan the governor would support, but he sharply rejected notions that Fallin would reconsider her refusal of the Medicaid expansion.

He added that Fallin had requested a renewal of the Insure Oklahoma waiver but had been denied, casting an option based on the program into doubt.

“If we had a plan in mind, something that we knew we wanted to do, we’d just be pursuing it,” Weintz said. “We are waiting on (Leavitt’s) thoughts and recommendations, and we’ll look at them with an open mind.”

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