The state’s deep and prolonged budget crisis has taken a serious toll on public services in Oklahoma.  We have seen rate cuts to providers of community-based health services, elimination of violence prevention programs for at-risk youth, closures of facilities for persons with mental health and addiction problems, and layoffs of hundreds of teachers and public employees, to cite just a few examples (see our updated compilation of state and local cuts). Overall, as we laid out in our FY ’11 Budget Highlights fact sheet, state appropriations have been cut by almost $400 million, or 7.2 percent, compared to FY ’09, and more than half of all appropriated state agencies must absorb state funding cuts of at least 15 percent.

Yet the impact of the downturn would have been genuinely catastrophic had Congress not provided substantial fiscal relief to the states as part of last year’s stimulus bill.  Formally known as the American Recovery and Reinvestment Act,  the stimulus bill provided states money in two basic forms – a State Fiscal Stabilization Fund, intended primarily for common and post-secondary education, and enhanced federal matching funds for Medicaid. Over the past two years, the Legislature approved the use of $1.375 billion in stimulus funds, allocated as follows:

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One of the most important provisions of the stimulus bill passed by Congress last February was the assistance provided to beleaguered state budgets in the form of enhanced federal matching rates for Medicaid. Now, as Oklahoma and other states remained mired in a deep fiscal crisis, the prospects seem good for an extension of the enhanced federal Medicaid match for an additional six months. This is one of the few promising signs on the fiscal horizons, and good news for the hundreds of thousands of Oklahoma families that receive health insurance coverage through Medicaid. Read the rest of this entry »

With Oklahoma in the midst of what is certain to be a severe and extended fiscal crisis, protecting core public services in every area of state government from deep and painful budget cuts poses a great challenge. However, protecting the budget of Medicaid, the main health insurance program for low-income children, seniors, pregnant women, and persons with disabilities, will present policymakers with special difficulties.

As noted in a recent fact sheet from the Kaiser Commission on Medicaid and the Uninsured, state Medicaid budgets face two distinct dilemmas: “the crunch” and “the cliff”. The crunch refers to the surge in Medicaid enrollment and spending associated with the economic downturn, as those losing jobs and access to employer-based coverage turn to Medicaid for coverage. Nationally, the Kaiser Commission found that total Medicaid spending growth averaged 7.9 percent across all states in FY 2009, the highest rate of growth in six years. As we reported in our last Numbers You Need bulletin, Oklahoma’s SoonerCare (Medicaid) enrollment climbed 8.9 percent between August 2008 and August 2009 and shows no signs of letting up. Read the rest of this entry »