Under the new national health care law, the Patient Protection and Affordable Care Act (ACA), one major strategy for providing health insurance coverage to the 50 million Americans who are currently uninsured is an expansion of eligibility in the Medicaid program. Even though the federal government will assume the lion’s share of the costs of insurance for those who gain Medicaid coverage, this expansion has created concern and uncertainty about the impact the law will have on state budgets.

We do not yet have a comprehensive study of the projected costs and savings of the Affordable Care Act for Oklahoma’s state budget. However, as a new OK Policy issue brief shows, most studies of the impact of the Affordable Care Act have concluded that increases to state Medicaid budgets will be modest. National studies from the Urban Institute and projections developed by the Oklahoma Health Care Authority have estimated that state spending on Medicaid may grow by $200 to $800 million between 2014 and 2019 or 2020, depending on various assumptions, while increasing state Medicaid spending by under 10 percent.  The federal government will assume over 90 percent of total costs of expanded Medicaid coverage. To cite the conclusion of the study by John Holahan and Irene Headen, the Urban Institute’s experienced and widely-respected health policy analysts: Read the rest of this entry »

This is the eleventh in an ongoing series of posts examining the Affordable Care Act, including previous posts on state insurance exchange flexibility and rate review. For links to all previous posts and additional resources, please visit the health care reform page on our website.  If you have thoughts on health care reform, we encourage you to comment below or contribute a guest blog.

Over the last decade, many American businesses have radically transformed their operations with networked, computer-based processes,  yet health care is one of the few industries that still relies primarily on paper records.  To address the technology gap in the health care professions, the new federal health care law contains several provisions aimed at modernizing the American health care system.  The Patient Protection and Affordable Care Act makes substantial investments in health information technology and introduces new regulatory standards for their adoption.  This post explores how these new requirements and closely affiliated initiatives like the HITECH Act, part of the American Recovery and Reinvestment Act in 2009, are being used to improve the quality of health care in Oklahoma. Read the rest of this entry »

Please visit the health care reform page on our website for links to previous posts and additional resources, including our ongoing series examining the Affordable Care Act.

The deadline for Oklahoma to begin operating an online health insurance exchange is just over two years away.  Insurance exchanges, a major component of the federal health care law, are state-operated online marketplaces where private insurance will be bought and sold with robust consumer protections.  Only two states currently operate functioning insurance exchanges – Massachusetts and Utah.  While progress has stalled in developing an Oklahoma exchange, legislative leadership are clearly fans of the Utah model, expressing admiration last session for their “free-market” approach.

Oklahoma legislators should proceed with caution before designing an exchange based on the needs of another state’s consumers. While Utah has been held up as a model for states looking for guidance in developing their exchange, their experiment has not been an unqualified success.  Problems with low enrollment and premiums that offer no cost advantage over the traditional market continue to challenge exchange administrators.  Rather than opting for a copycat exchange, Oklahoma will be better served by a health insurance exchange that accounts for the unique needs and characteristics of Oklahomans. Read the rest of this entry »

What’s up this week at Oklahoma Policy Institute? The Weekly Wonk is dedicated to this week’s events, publications, and blog posts.

This week at OK Policy, we posted our tenth blog in an ongoing series of posts examining the Affordable Care Act.  While the federal government has repeatedly assured the states “flexibility” in instituting the new health law’s requirements, if a state isn’t making a timely and good faith effort to launch a health insurance exchange, their efforts may be preempted by a federally-run exchange. Read the rest of this entry »

This is the tenth in an ongoing series of posts examining the Affordable Care Act, including previous posts on rate review and temporary high risk pools. For links to all previous posts and additional resources, please visit the health care reform page on our website.  If you have thoughts on health care reform, we encourage you to comment below or contribute a guest blog.

Earlier this year, we blogged about health insurance exchanges, a major provision of the federal health care reform law, the Affordable Care Act (ACA).  In a nutshell, states have been tasked with setting-up online insurance marketplaces, or “exchanges,” for selling private coverage and determining eligibility for premium subsidies or public health insurance programs.  The online exchanges envisioned by the Affordable Care Act institute robust consumer protections, simplify plan and premium comparisons, and facilitate competition.  The deadline for states to gain approval for their exchange plans from the federal government is January 2013, and the deadline for having their online insurance marketplace up and running is January 2014. Read the rest of this entry »

As states and Washington grapple with ongoing budget shortfalls, the Medicaid program is often in the crosshairs of those calling for major reductions in government spending. But while the costs of funding Medicaid are readily apparent, we should not forget the program’s crucial role in providing health care for those who may be too poor or too unhealthy to buy coverage in the commercial insurance market. Recently, a path-breaking new study reported that when those without health insurance are enrolled in Medicaid, they see wide-ranging benefits in terms of access to health care services, better physical and mental health, and financial stability. These findings should assume great importance in ongoing state and federal debates on Medicaid and health care reform.

Medicaid is the primary source of health insurance for low-income children, pregnant women, seniors, and individuals with disabilities. The federal-state program covers 47 million Americans, or just under one in five of all those with health insurance coverage (2009). In Oklahoma, 728,594 persons are covered by Medicaid as of May 2011; the majority (63 percent) are low-income children. Medicaid is administered by the states with the federal government assuming a majority share of the costs. Read the rest of this entry »

What’s up this week at Oklahoma Policy Institute? The Weekly Wonk is dedicated to this week’s events, publications, and blog posts.

This week at OK Policy, we presented interactive charts tracking state agencies’ share of the budget over time.  A series of visualizations show that while revenues have fallen over the past decade and the overall budget pie has shrunk, the distribution of that pie among agencies has remained relatively unchanged (with a couple notable exceptions). Read the rest of this entry »

Legal challenges to national health care reform have proliferated since the Affordable Care Act (ACA) became law in March 2010.  There have been 26 federal lawsuits filed seeking to overturn the legislation, most of them challenging the constitutionality of the ‘individual mandate’ – the requirement that all Americans carry health insurance by 2014 or pay a tax penalty.  Proponents of the ‘individual mandate’ contend that the health care sector takes up a rapidly growing share of interstate commercial activity and the Constitution grants Congress the power to regulate that commerce.  Opponents argue that the Constitution’s commerce clause applies only to economic activity; because the decision not to buy insurance is economic inactivity, there is no constitutional basis for Congressional regulation.

Twenty-six states have banded together and jointly filed Florida vs HHS. This is the most watched of all the legal challenges to the new health care law because of its size and the likelihood that it will be granted an expedited hearing before the U.S. Supreme Court. Oklahoma and Virginia have each filed separate legal challenges. In addition to the states, lawsuits have been filed by plaintiffs from all walks of life, including individual citizens and small groups, businesses and business-owners, physicians, associations, hospitals, universities, and lawyers.

With so many different cases working their way through our complicated judicial system, it’s easy to lose track of the big picture.  This post breaks it down, beginning with the Federal District Courts, the first stop for any case on its way to a Supreme Court hearing.  This chart shows the outcome of district court challenges to date:

Read the rest of this entry »

This is the ninth in an ongoing series of posts examining the Affordable Care Act, including previous posts on health insurance exchanges and temporary high risk pools.  You can also visit the health care reform page on our website for more resources and information.  If you have thoughts on health care reform, we encourage you to comment below or contribute a guest blog.

Addressing the rising costs of care was a driving force behind the passage of national health care reform.   During the long and contentious debates leading up to reform, members of Congress, the media, and the public could all agree on one fact:  health care costs are rising and they are rising fast.  Family premiums for employer-sponsored health coverage increased by 131 percent between 1999 and 2009.  Many factors contribute to the growth of health care spending over time, for example, the enormous expense of supporting an aging population with a longer life span and a greater prevalence of chronic disease.  In addition to a long list of well-documented and legitimate cost drivers, some insurers engage in accounting practices that overestimate expenses and underestimate revenue, artificially inflating consumer premiums.  I recently attended a conference on how to protect consumers from excessive premiums and make health insurers justify rate hikes, hosted by Consumers Union, the nonprofit publisher of Consumer Reports. Read the rest of this entry »

This post by Dave Chandra originally appeared here on the Center for Budget and Policy Priorities (CBPP) Off the Charts Blog.  OK Policy recently blogged about two unsuccessful bills this session to establish Oklahoma’s Health Insurance Exchange.  To learn more about exchanges and their requirements under the new federal health reform law, click here.

The continuing rhetorical battle over health reform shouldn’t obscure the fact that states are taking important steps to implement last year’s historic legislation.  For example, virtually every state has made at least some progress toward setting up health insurance marketplaces or “exchanges,” which will give individuals and small businesses affordable, comprehensive coverage options.  The Affordable Care Act calls for states to have exchanges up and running in January 2014.

California and Maryland have been out front:  both states have enacted laws setting up their exchanges and appointed the boards that will run them.  Now they’re beginning to tackle the key issues that must be resolved for the exchanges to succeed. Read the rest of this entry »

Sweeping changes to the nation’s health care system were enacted in recent years and talk of even more changes continues to reverberate in debates over the federal budget.  Central to the discussion and always a lightning rod in health care debates is the future of Medicare, a federally subsidized health insurance program for people over 65 or with certain disabilities.  Beyond policy change, there are myriad factors potentially affecting older Oklahoman’s access to medical care:  the recent recession, rising health care and prescription drug costs, and the state’s budget shortfall.  This post provides older Oklahomans with information from and links to trusted sources what is changing with respect to Medicare.

The new national health care law, known as the Affordable Care Act (ACA), went into effect on March 23, 2010.  The official ACA website for seniors is: http://www.healthcare.gov/foryou/seniors.  You can watch a video on what to expect from Medicare in 2011 or learn more about paying for long-term care.  Since the ACA was enacted, 57, 068 Medicare beneficiaries in Oklahoma have received a tax-free $250 dollar rebate check to help pay for medication and prescription drug benefits will continue improve for seniors over the next decade, eventually bridging the coverage gap or “donut hole.”  575,000 seniors in the state are now eligible for free preventative services, like mammograms and colonoscopies, and a free annual wellness check.  Medicare will not change drastically under the ACA, but it does provide substantial incentives to promote preventative care and wellness. Read the rest of this entry »

It was a busy session.  Last Friday marked the deadline for Governor Fallin to take final action on bills that landed on her desk. Now that sine die has passed, we thought it would be useful for OK Policy to do inventory and update you on the status of the bills we wrote about this session on our blog.

There were over two dozen immigration bills introduced this session.  Neither of the ‘English only’ bills, HB 2083 and SB 905, intended as implementing legislation for State Question 751, were approved by the legislature.  On our blog, we advised against passage and pointed out that the bills would have imposed new and draconian restrictions on speech and potentially entangled state officials in a legal double bind.  We also blogged about two bills, SB 683 and HB 1446, that sought to rescind resident tuition eligibility for undocumented high school students enrolling in public colleges and universities.  The stand alone bill, SB 683, died in House committee and the sections pertaining to resident tuition eligibility were removed from HB 1446 in conference committee.  We have blogged extensively about other sections of HB 1446, the omnibus immigration legislation which went through several incarnations and was eventually defeated on the House floor by a vote of 62 (N) to 31 (Y). Read the rest of this entry »