On June 30, 2020, the Oklahoma Medicaid Expansion Initiative, State Question 802, passed by a majority vote to expand Medicaid eligibility to adults ages 19-64 whose income is 138% (133% with a 5% disregard) of the federal poverty level or lower. OHCA will seek at least 3 plans to provide statewide network coverage. When Obamacare became law on March 23, 2010, it envisioned a mandatory expansion of Medicaid that would take effect in 2014. After two years, the group of Medicaid enrollees showed "no significant improvements in measured physical health outcomes" compared to the uninsured patients. The ACA Medicaid expansion proposed that eligibility requirements should be expanded to include more applicants into the program. Similarly, the fallout from coronavirus has sent Missouri's state revenues into negative territory, requiring budget cuts of at least $700 million in order to balance the state's books. The expansion begins July 1, 2021. On June 18, 2020, Governor Kevin Stitt and Oklahoma Health Care Authority (OHCA) CEO Kevin Corbett announced the state would seek proposals from qualified managed care organizations (MCOs) to improve health outcomes, increase access to care, and increase system accountability in the Medicaid program (SoonerCare). Opinions expressed by Forbes Contributors are their own. Oklahoma is now the 37th state to expand Medicaid under the Affordable Care Act; coverage will begin a year from now, on July 1, 2021. Federal guidelines don’t allow Medicaid members to receive inpatient services at free-standing psychiatric hospitals, and they cap crisis stabilization beds at 16 statewide. The Request for Proposals (RFP) is … On June 18, 2020, Governor Kevin Stitt and Oklahoma Health Care Authority (OHCA) CEO Kevin Corbett announced the state would seek proposals from qualified managed care organizations (MCOs) to improve health outcomes, increase access to care, and increase system accountability in the Medicaid program (SoonerCare). This website is not compatible with Internet Explorer. Researchers compared more than 6,000 patients randomly chosen to enroll in Medicaid with a control group of similarly situated uninsured patients. A study by the Foundation for Government Accountability found that, as of 2018, states that expanded Medicaid had enrolled twice as many newly eligible patients as originally anticipated. Sue Ogrocki - staff, AP All income standards are expressed as a percentage of the federal poverty level (FPL). You may opt-out by. All this spending doesn't even purchase high-quality care. Ohio saw cost overruns of more than 100% after expanding its Medicaid program. (AP Photo/Sue Ogrocki). “Even though the makeup of the Legislature has significantly changed, I’m thrilled to see that the governor is continuing to push forward with the desperately needed Medicaid expansion,” said Rep. Kathy Wolfe Moore, a Democrat from Kansas City, Kansas. MCOs will be required to cover services under appropriate OHCA State Plan and Waiver authority. The coverage is enabled by a grant from the Anne & Henry Zarrow Foundation. People who do not choose a plan will have one assigned to them. How Oklahoma Voted on Medicaid Expansion by Jesse Howe July 1, 2020 An ongoing series on efforts in Oklahoma to extend health coverage to thousands of uninsured people through Medicaid expansion or other approaches. Oklahoma is the fifth state to use a ballot measure — voted on by state residents — to expand eligibility for Medicaid; 200,000 residents are expected to gain coverage. Oklahoma will become the latest state to adopt the Affordable Care Act ’s Medicaid expansion after voters passed a ballot measure Tuesday that aims to cover an estimated 200,000 low-income adults. The two most recent expansion states were Missouri and Oklahoma. For starters, 10% of the costs for newly eligible enrollees is still a substantial sum. A Medicaid expansion would extend health insurance to low-income adults who earn up to 133% of the federal poverty level, or $16,970 for an individual and $34,846 for a family of four. Voters in Oklahoma's urban metro areas overwhelmingly approved the question to expand Medicaid, but rural voters largely opposed the measure. In a survey from 2017, Medicaid patients reported being in poorer health than either uninsured Americans or those with other forms of coverage. Oklahoma Voters Approve State Medicaid Expansion The vote will extend benefits to about 200,000 uninsured people in the state, rebuffing efforts by Gov. Members will have opportunities to switch their plan. Oklahoma voters on Tuesday approved a state question to expand Medicaid, but legislators won’t decide until next year how to pay for the expansion. Responding to this fiscal crisis with a drastic increase in mandatory health spending is lunacy. This table reflects the principal but not all MAGI coverage groups. The Request for Proposals (RFP) is currently in development, with a planned release this fall and an anticipated implementation date of October 1, 2021. OHCA may share this personally identifiable data with its authorized business associates, government agencies with jurisdiction over the OHCA, or as otherwise required or permitted by applicable law. This data is treated as confidential and is stored securely in accordance with applicable law and regulations. Missouri could follow suit next month when a similar ballot initiative comes up for a vote. That said, the focal point will be on long term care, whether that be at home, in a nursing home, or in an assisted living facility. That means TSET money cannot be used to partially pay for the state’s Medicaid expansion. But, that just changed for Oklahoma. This equates to an estimated annual income of $16,970 for an individual or $34,846 for a family of four. 3RD PARTY CAPITATED MANAGED CARE. Appendix Table 1: Total Medicaid Enrollment, FY 2019 (In Thousands) State Expansion Status Total Enrollment Traditional Group Expansion Group Expansion Group (%) United States — 75,176 59,829… (CNN) Oklahoma voters decided Tuesday that the deep-red state should expand Medicaid to low-income residents. Voters rejected State Question 814 … A much-anticipated Medicaid expansion is coming to Oklahoma in 2021 after years of resistance from Republicans in the Legislature and the governor's office. Supporter awaited results in a virtual watch party as Oklahoma voters decided whether to amend the state Constitution to expand Medicaid health coverage to tens of thousands of low-income residents. Children, including foster children, low-income parents, pregnant women, and adults ages 19-65 (expansion population) will be enrolled. Late last month, Oklahoma voters narrowly approved a ballot measure expanding the state's Medicaid program to childless adults making up to 138% of the poverty level under the terms of … Late last month, Oklahoma voters narrowly approved a ballot measure expanding the state's Medicaid program to childless adults making up to 138% of the poverty level under the terms of Obamacare. Oklahoma Health Care Authority CEO Kevin Corbett said the approval comes at a critical time. By expanding Medicaid, governments in Oklahoma and Missouri could end up spending hundreds of millions of dollars on an insurance program that doesn't benefit patients. Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Just look at the landmark study of an expansion of Oregon's Medicaid program in 2013. By one estimate, improper payments—a substantial portion of which go toward patients who aren't legally eligible for the program—now total $75 billion a year. Medicaid is a health care insurance program, jointly funded by the state and federal government, for low-income individuals of all ages. Given how badly the coronavirus pandemic has battered state budgets and undermined public health, a massive influx of federal healthcare dollars would appear to be a huge help. Kevin Stitt to prevent an expansion. Her latest book is False Premise, False Promise: Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Based on … More than 833k — mostly children — are enrolled in Medicaid in Oklahoma (about 5% higher than enrollment in 2013, with significant enrollment growth in the spring of 2020 amid the COVID-19 pandemic) Individuals enrolled in SoonerCare due to their status as “aged, blind or disabled (ABD)” will initially remain in fee-for-service and will be phased in at the appropriate time. While there are many different eligibility groups, this page is focused specifically on Medicaid eligibility for senior Oklahoma residents (65 years of age and older). It's anyone's guess where this money will come from. State Question 802 requires the state to expand Medicaid by July 1, 2021 — the start of the next fiscal year. A MCO program will allow the state to coordinate SoonerCare members’ needs with the best provider to meet those needs, while containing costs through a capitated, risk-based model. The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. To ensure each member has a health plan responsible for their care and health, the SoonerCare application will include a choice of plans. On June 30, 2020, the Oklahoma Medicaid Expansion Initiative, State Question 802, passed by a majority vote to expand Medicaid eligibility to adults ages 19-64 whose income is 138% (133% with a 5% disregard) of the federal poverty level or lower. If you are experiencing difficulties, please try a different Internet browser (Chrome, Firefox, Edge or Safari). Oklahoma is poised to become the 37th state to expand Medicaid to cover more low-income residents after voters narrowly approved State Question 802 on Tuesday. Despite the clear benefits of expanding the program, only 36 states and Washington DC have implemented Medicaid expansion thus far, with Missouri and Oklahoma in the process of doing so. Adults (Medicaid) Expansion to Adults: Eligibility Level : 1. For two states simultaneously battling a deadly pandemic and a fiscal crisis, it's hard to imagine a worse use of resources. Major services included: Behavioral Health, Pharmacy. Electronic Health Record Incentive Program, SoonerCare Out-of-State Services Rule Changes, Comprehensive Managed Care Program Feedback, Enhance care coordination efforts to improve health outcomes and member experience, Provide value-add services to address social determinants of health and barriers to treatment, Modernize payment model from fee-for-service to a model that incentivizes value and outcomes. Follow her on Twitter @sallypipes. © 2021 Forbes Media LLC. This equates to an estimated annual income of $16,970 for an individual or $34,846 for a family of four. But in 2012, the U.S. Supreme Court deemed the expansion optional for states. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All, (Encounter 2020). In California, costs exceeded projections by more than $32 billion in the course of just two and a half years. The opportunity to accept the Affordable Care Act Medicaid expansion in Oklahoma along with the rest of the states in the country was presented in 2012. Missouri residents also will weigh in on whether to adopt Medicaid expansion in August. But Obamacare's Medicaid expansion isn't the gift to states it's often made out to be. Per-patient costs, meanwhile, were 76% higher than initial estimates. Senior citizens and people enrolled in both Medicare and Medicaid will initially remain in fee-for-service. Voters in Oklahoma narrowly approved an expansion of Medicaid on Tuesday night, making it the latest conservative-leaning state to approve … But the report anticipates a net cost of $49 million to $81 million when anticipated savings in existing programs across state government are also considered. On the contrary, it can put states on even shakier financial ground while doing little to improve the health of patients. Supporter awaited results in a virtual watch party as Oklahoma voters decided whether to amend the state Constitution to expand Medicaid health coverage to tens of thousands of low-income residents. An Oklahoma Medicaid expansion initiative was approved by voters in June 2020; expansion will take effect in July 2021. Such unplanned expenses are exactly what one should expect from a program as rife with fraud and abuse as Medicaid. Medicaid expansion seems like a great deal for states. 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According to one analysis, Oklahoma's expansion is likely to bring more than 200,000 people, out of the total state population of 4 million, into the program at a one-year cost to the state of more than $200 million. State lawmakers are scrambling for ways to cut spending by as much as 10%. Oklahoma voters narrowly approved Medicaid expansion this July, making it the 37th state to broaden the safety net program to a greater share of … OKLAHOMA CITY (KFOR) – Oklahomans voted no on State Question 814. The 2013 Leavitt report estimated that the state’s share of the costs would range from $137 million to $158 million if Oklahoma Medicaid expansion took effect in 2021. The promise of billions of federal dollars has been enough to entice 37 states, including most recently Oklahoma, and the District of Columbia to sign on to the expansion. Thanks to a new policy, low-income Oklahomans will soon have better access to in-patient mental health and addiction services. On January 30, 2020, the Trump Administration announced the Healthy Adult Opportunity (HAO) program, an optional program within Medicare and Medicaid that was designed to give states "new levels of flexibility in the administration and design of their Medicaid programs while providing federal taxpayers … Do a little arithmetic, however, and it becomes clear that expanding Medicaid—which covers nearly 71 million people—is a recipe for fiscal calamity. The federal government picks up 90% of the tab for new enrollees. And if the first decade of Obamacare has proven anything, it's that expanding Medicaid is almost always more expensive than expected. The state is … Enrollment in Medicaid coverage under expansion began on November 1, 2019, and coverage for these enrollees began on January 1, 2020. Still, it makes Oklahoma the fifth state controlled by Republicans to approve Medicaid expansion through a ballot measure, joining the ranks of Idaho, Maine, Nebraska and Utah. All Rights Reserved, This is a BETA experience. Prior to the vote, 36 states and the District of Columbia already had expanded Medicaid using money from the 2010 health care law. Oklahoma already faces a budget shortfall of more than $1.3 billion, largely as a result of lost revenues due to COVID-19. “With Medicaid expansion beginning July 1, many Oklahomans with behavioral health disorders will be able to access the appropriate care at the right place when … Oklahoma voters on Tuesday narrowly approved a ballot measure to extend Medicaid to tens of thousands of poor adults, making their state the … Now voters have given the state legislature an assignment: Find another way to pay for it. Amber England, campaign manager for Yes on 802, addresses supporters via the internet Tuesday, June ... [+] 30, 2020, in Oklahoma City. The ballot initiative, which began … American Indian/Alaska Native members are considered voluntary and will have the option to opt in to a managed care plan. 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