SoonerCare 2.0’ coming

The 2020 Oklahoma Legislature opened its session Monday while Gov. Kevin Stiff announced plans to reform Medicaid in Oklahoma.

Stitt met with Trump administration officials, Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, in Washington, D.C., to announce the Healthy Adult Opportunity (HAO), which is an optional demonstration initiative by CMS to gives states innovative health coverage programs for adults under age 65 for whom Medicaid coverage is optional.

Stitt is calling his new Oklahoma healthcare plan SoonerCare 2. In it, he said Oklahoma would get full federal Medicaid funding without new taxes. Stitt said the new program – one of the first of its kind in the nation – will combine personal accountability with better healthcare.

“My administration has been working on SoonerCare 2.0 to capture our total federal dollars under Medicaid in a way that is more stable and accountable,” Stitt said. “Healthy Adult Opportunity couldn’t come at a better time. This initiative will now allow Oklahoma maximum opportunity to achieve what we were envisioning.”

Beginning with the Obama Administration, state lawmakers turned down federal funds with strings attached because the enormous price tag attached to Medicaid. There is an effort to bring a petition to force acceptance of Obamacare funds.

“…Oklahomans want their federal tax dollars to be returned to the state and put to work,” Stitt said. “But efforts to do this through amending our Constitution to force Medicaid Expansion are wrong and will be ineffective and will fail to fix our problems. 

“We’ve been studying the best practices in all 50 states; and we’ve learned a lot about what is working and what isn’t. And one thing we know without a doubt is that there is not a one-size-fits-all approach to delivering better healthcare and better outcomes. Every state has their unique challenges, their unique climates, and their own cultures.  That is why the Trump administration’s announcement today is a game changer.”

Stitt said the Oklahoma Health Care Authority will begin taking steps on implementing SoonerCare 2.0 by applying for additional federal funds and the HAO flexibility waivers.

Some of the changes are:

• Medicaid will start to focus on rewarding healthy outcomes and better care.
• Oklahoma will go away from the government-run, fee-for-service model that has been abandoned by 40 states.
• The reform will focus first on those will become eligible under SoonerCare 2.0.
• There will be expectations for able-bodied individuals to get off Medicaid at some point.
• Oklahoma will charge modest premiums to get clients used to the idea of private health insurance.
• It will establish work requirements that encourage growth of personal potentials through education and other means.
• It has help for rural health.
• It will target expanded treatment for opioid addiction and substance abuse.

“Oklahoma is in the midst of establishing a world-class research institution on opioid addiction,” Stitt said. “With HAO flexibility, we will be able to more quickly support our communities and implement lessons we are learning and discovering.”

It has drawn legislative support.

“At first glance, the governor’s plan swiftly brings our federal dollars home to help Oklahomans in a far more responsible fashion than the state question,” said House Speaker Charles McCall. “It also has responsible funding mechanisms, which the state question does not. The state question forces the Obamacare federal model upon states, and the Trump-Stitt plan puts states in charge of their own healthcare and health outcomes. We will discuss more details in the coming days, but it is a highly promising plan.”

Stitt’s plan has drawn criticism from the Oklahoma Council of Public Affairs.

“Republican plans to expand welfare aren’t any better than Democrats’ plans to expand welfare,” said OCPA President Jonathan Small. “In fact, sources ranging from the Government Accountability Office to state actuaries have found that Republican plans to expand welfare in Indiana, Arkansas and other places actually cost more than Democrats’ welfare-expansion plans. The broad proposal unveiled today basically adds conservative window dressing to Obamacare’s expansion of Medicaid, and the result of expansion will be the same as what we have seen in other states: exploding costs, higher taxes, and stagnant or worsening health outcomes.

“Any form of Medicaid welfare expansion mostly serves to enrich big-box urban-based hospitals and big insurance companies while failing rural areas,” Small said. “Medicaid expansion consistently fails to generate meaningful improvement in health outcomes, and indirectly rations care for the most vulnerable already on Medicaid, while increasing health care prices for everyone else due to the cost-shifting that occurs because of Medicaid.

“And the icing on the cake is Medicaid expansion has led to increased taxes in many cases. There’s nothing in Oklahoma’s proposal under the federal waiver that would change that trajectory. In fact, Oklahoma would be required to offer and pay for even more services under this proposal than under traditional Medicaid expansion.”