OK Policy has argued repeatedly  that next year’s budget outlook, with shortfalls equal to cuts of 12 percent across all agencies of state government above those already enacted this year, threatens to have catastrophic consequences for the state’s economy, businesses, and families (see our budget page for an op-ed, issue brief and fact sheet, or this blog post). Here we examine the especially grim options for dealing with budget shortfalls faced by the Oklahoma Health Care Authority (OHCA), the state agency responsible for administering the state Medicaid program that serves nearly 700,000 low-income Oklahomans, primarily low-income children, seniors, pregnant women, and persons with disabilities.

At recent legislative hearings, the agency outlined next year’s budget situation. This year, the agency’s state funding – after budget cuts and including $33 million in additional funds that were authorized as part of the mid-year “supplemental” approved by the Legislature – is $980 million. As a result of increased enrollment and utilization, OHCA estimates that it will need $1.098 billion in state appropriations to maintain the Medicaid program in FY ‘11 at its current levels. If, as is possible, the Legislature were to remove the supplemental from OHCA’s base and cut funding by an additional 10 percent, its appropriation for FY ‘11 would be some $850 million. Thus, OHCA anticipates that it could be facing a shortfall for the coming year of some $250 million in state funds. With the corresponding loss of federal matching funds, the program would face the challenge of enacting total cuts of at least $1 billion. Read the rest of this entry »

According to the latest U.S. Census figures, 565,000 Oklahomans, or 15.8 percent of the total population, were without health insurance in 2007-2008. The uninsured rate is just under 10 percent for children but over 20 percent for adults ages 18-64.

The Oklahoma Legislature has made several efforts in recent years to chip away at the number of uninsured by expanding eligibility for Insure Oklahoma, a program that provides public subsidies towards the purchase of employer-sponsored coverage for employees of small businesses or a public product for those without access to employer coverage. Eligibility for Insure Oklahoma goes up to 200 percent of the federal poverty level ($44,000 for a family of four) and is available to employees of businesses with up to 250 employees. Read the rest of this entry »

In the early 1990’s, faced with health care costs that were rising at unmanageable rates and widespread dissatisfaction with the quality of the state’s Medicaid program, the Oklahoma Legislature created the Oklahoma Health Care Authority (OHCA) as  a stand-alone agency whose primary mission would be to convert the state’s fee-for-service Medicaid program into a primarily managed care program. To implement managed care, the state submitted a Section 1115 demonstration waiver for the program, which would come to be known as SoonerCare. Earlier this year, Mathematica Research, a nationally-recognized evaluation company, delivered a comprehensive 1115 waiver evaluation on the SoonerCare program since its inception. You can access an Executive Summary of the findings, a PowerPoint, or the 175+-page full report. Read the rest of this entry »