Trying to Head Off Petitioners?

Stitt Requests Moderate Medicaid Expansion Plan for Oklahomans

State Rep. Emily Virgin, the minority leader of the State House of Representatives, is among those who are demanding that the governor schedule a state question on the ballot for the expansion of Medicaid services.  Here, she is being sworn-in.

The Oklahoma Health Care Authority submitted to the federal government a state plan amendment seeking to moderately expand Medicaid in Oklahoma as soon as this summer.

The submission on Friday came just a day after those working to have Medicaid expansion to be voted on in a state question, submitted a number of signatures demanding that the proposed state question be scheduled for a ballot vote.

Those supporters of a state question sponsored a petition drive last year that garnered far more signatures than required by law for the state question to be scheduled for a vote, but the governor has not scheduled the state question for a ballot vote.

“The agency has the he authority to send in the paperwork to expand, and we’re going to get that out on Friday,” Gov. Kevin Stitt told reporters earlier last week.

The state plan amendment will get the ball rolling for Oklahoma to seek federal approval to expand Medicaid, but in a way that is less pervasive than will be required if a proposed state question is passed.

When a state wants to change its Medicaid program, the state must submit to the federal Centers for Medicare & Medicaid Services a state plan amendment for review and approval. 

The amendment is separate from the Healthy Adult Opportunity waiver the governor has expressed an interest in seeking.

As the governor seeks to move forward with expanding Medicaid on July 1 through his SoonerCare 2.0 plan, he’s still in talks with the Legislature on how to fund the expansion.

If Oklahoma expands Medicaid, the state will have to cover 10 percent of the costs, which consultants for the governor have estimated will be around $150 million annually. 

The federal government would cover the other 90 percent, which will be around $1 billion annually.

Should the federal government give Gov. Stitt approval to expand Medicaid, state legislators–who control state appropriations–will have to fund the expansion, said State Sen. Greg McCortney (Rep., Ada).

“If the governor unilaterally expands Medicaid, we will have to pay for it,” State Sen. McCortney said.

“Constitutionally, we’re required to vote on a balanced budget, so if we have expanded Medicaid, we will have to pay.”

Gov. Stitt said he thinks he’s close to a funding deal with the State House, State Senate and hospital industry, which may have to pay higher fees to help cover the state’s share of the expansion. 

The state doesn’t have to submit a funding proposal as part of the state plan amendment, the governor stated.

McCortney agreed legislators and the governor appear close to a deal.

One of the sticking points appears to be the Supplemental Hospital Offset Payment Program, a hospital fee that may be increased to fund the expansion. 

Saying Oklahoma hospitals wouldn’t have time to budget for a fee increase that would take effect this year, the Oklahoma Hospital Association pushed back against the increase.

Gov. Stitt wants to raise the fee to 4 percent, the highest point allowable under current state law., but State Senate lawmakers have indicated they don’t want to raise the fee higher than 3.25 percent because the fee, which is based on Medicaid expenses, fluctuates annually.

The governor said he wants legislators to change state law so the fee, which helps fund the state’s current Medicaid population, can also be used to cover the expansion population.

“We’re going to be talking about how you fund it, whether it’s SoonerCare 2.0 or if the state question passes,” Gov. Stitt said.   “We’ve got to have this discussion.  Let’s just talk about it, let’s put this to bed and move on.”

Legislators are looking at a multitude of funding options, said State Senate Pro Tem Greg Treat (Rep., Oklahoma City).

“We have given a couple of proposals,” State Sen. Treat said.   “We’re waiting to get more specific details from the governor’s office.”

Gov. Stitt proposed his SoonerCare 2.0 expansion plan as an alternative to State Question 802, which seeks to expand Medicaid in Oklahoma by inserting it into the State Constitution. 

Unlike the state question, Gov. Stitt seeks to impose modest premiums and work requirements on those who would receive Medicaid benefits under an expansion.

Supporters of SQ 802 are pushing Gov. Stitt to set an election date for the question. 

Together Oklahoma, the advocacy group for the Oklahoma Policy Institute, delivered to the governor’s office Thursday a petition signed by hundreds of Oklahomans asking Stitt to set a date.

“Oklahomans are tired of waiting,” commented State House Minority Leader Emily Virgin (Dem., Norman).

“Full Medicaid expansion through the state constitution is the cleanest, most transparent way to expand health care coverage in Oklahoma,” she said in a statement. 

“It’s time for the governor to do his job by announcing an election date so Oklahomans can decide best how to proceed.”

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