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Funding shortfalls motivate finding waste… but also ending important services (Capitol Updates)

by | July 2nd, 2015 | Posted in Budget, Capitol Updates, Healthcare | Comments (0)

Steve Lewis served as Speaker of the Oklahoma House of Representatives from 1989-1991. He currently practices law in Tulsa and represents clients at the Capitol. You can sign up on his website to receive the Capitol Updates newsletter by email.

Agencies are continuing to craft their FY-2016 budgets based on the legislative appropriations. Both those who believe there is waste in government and those who believe there’s a lack of adequate funding can point to examples. A case in point came up this week in the Oklahoma Healthcare Authority Board meeting during proposed rule changes to deal with its FY-2016 budget. OHCA got an increase over this year but not enough to cover the cost of current services for all of next year.  So some programs were on the chopping block.

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Statement: Supreme Court health care decision is a victory for Oklahomans

Oklahoma Policy Institute released the following statement in response to the Supreme Court decision upholding subsidies for insurance purchased on the Affordable Care Act federal marketplace:

The Supreme Court decision is a victory for tens of thousands of Oklahomans and millions of Americans. The Affordable Care Act’s subsidies are helping more than 87,000 Oklahomans purchase affordable health coverage and making Oklahoma a stronger, healthier state.

This decision cements the reality that the Affordable Care Act is the law of the land and is here to stay. It is time for Oklahoma lawmakers to move past fruitless obstruction of the law and shift that energy into making sure that it succeeds in providing access to affordable coverage to as many Oklahomans as possible.

A good start would be to accept federal funds to extend health coverage to the 150,000 low-income, working Oklahomans in a “coverage crater” because they make too much to qualify for Soonercare but not enough to receive subsidies on the federal marketplace. States that have accepted federal dollars to expand Medicaid have seen large gains in the number of adults with health insurance and given more citizens access to lifesaving screenings and treatments, all while saving money in state budgets. Hospitals in expansion states are treating fewer uninsured patients, and the amount of “uncompensated care” they are providing is declining steeply.

Flat funding still means cuts for Oklahoma’s core services

by | June 9th, 2015 | Posted in Blog, Budget, Education, Healthcare | Comments (0)

In crafting a budget in the face of a large drop in available revenue, lawmakers this year made a sincere effort to minimize cuts to key agencies in the areas of education, health, and safety. Whereas most agencies took cuts of 0.25 to 7 percent, the Department of Education received flat funding, and the Oklahoma Health Care Authority, Department of Corrections, Department of Human Services and Department of Mental Health and Substance Abuse Services received modest funding increases.

Yet even these agencies weren’t funded enough to keep up existing services when faced with growing caseloads and enrollment, rising costs, reduced funding from other sources, and other factors. As a result, most will need to make cuts to next year’s budget.

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Oklahoma’s refusal of federal dollars especially hurts African-American and Hispanic families

by | May 28th, 2015 | Posted in Healthcare | Comments (1)

Drew Capps interned with OK Policy this spring and recently graduated from the University of Tulsa.

We’ve discussed previously, and at length, why Governor Fallin’s decision to reject federal funds to expand health coverage to low-income Oklahomans is the wrong move, especially when research shows that Medicaid expansion in other states has proven a good deal. Now, new analysis from Families USA lays out more of what Oklahoma gave up by not expanding coverage. Without the expansion, black and Hispanic Oklahomans are more likely to become ill from and die of chronic disease — and are also less likely to have insurance.

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The Data Is In: Oklahomans are actively using Affordable Care Act

by | May 14th, 2015 | Posted in Healthcare | Comments (0)

Steven Goldman, PhD is a Navigator at Oklahoma Primary Care Association. He can be reached at

Although the Affordable Care Act (ACA) recently reached its fifth year, the law’s main incentives for expanding health coverage are still young. The health care law’s second Open Enrollment Period just concluded in February 2015. Now the the enrollment data from the US Department of Health and Human Services is in, and it makes two important points: that Oklahomans are interested and engaged in purchasing health insurance on, and that those purchases are having a strong impact on the state economy.

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Prescription monitoring bill is a good first step. It’s also not enough.

by | May 4th, 2015 | Posted in Blog, Healthcare | Comments (0)

Photo via Gov. Fallin's Twitter

Photo via Gov. Fallin’s Twitter

Last year, we argued that the legislature had missed an opportunity by punting on a bill that would have required doctors to check the state’s prescription monitoring program (PMP) before writing a prescription for some of the most dangerous drugs, to make sure patients were not “doctor-shopping” or showing signs of addiction. This year, legislators righted that wrong, and a bill requiring doctors to check the PMP, although on a narrower range of substances and on a looser schedule, was signed into law by Governor Fallin on March 31.

HB 1948, sponsored by Rep. Doug Cox in the House and Sen. A.J. Griffin in the Senate, requires doctors to check the PMP before writing a prescription for opiates (such as oxycodone and Lortab), benzodiazepines (such as Xanax and Valium), and carisoprodol (Soma) the first time they see a patient and every 180 days thereafter. Prescribers must note the check in the patient’s chart. Providers writing such prescriptions for hospice and end-of-life care are exempt, as are nursing homes.

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Watch this: “Is Obamacare Working? The Affordable Care Act Five Years Later”

by | April 30th, 2015 | Posted in Healthcare, Watch This | Comments (1)

On the five-year anniversary of the signing of the Affordable Care Act, author and blogger John Green asks: is it working?

The answer is yes – and no. In the clip below, Green discusses the ACA’s successes, including a sharply declining uninsured rate, early indicators of better health outcomes,  an end to discrimination against people with preexisting conditions, and reduced job lock. He also discusses how there’s still work to be done on some fundamental issues in the health care system that contribute to America’s very high health care costs. As Green notes, “…the ACA didn’t replace the existing [health care] system so much as it grew on top of it.”

Watch the clip to see more.

Click through to the video page and choose “see more” in the video description box to see Green’s sources.

Federal Money As Promised (FMAP)

by | April 16th, 2015 | Posted in Blog, Healthcare | Comments (0)

It’s rare that Congress finds bipartisan consensus on important issues, but that happened last month when the House approved health care legislation that includes an extension of the State Children’s Health Insurance Program (SCHIP). Last night the bill was overwhelmingly approved by the Senate and is expected to be signed into law by President Obama.

Under this law, states will receive a substantially higher federal match rate for coverage of certain low-income children through 2017. Oklahoma will see a 23 percentage point jump in its SCHIP match rate in fiscal year 2016.

The temporary boost in the federal match was included in the Affordable Care Act passed in 2010 but was not initially funded. The higher match will boost federal Medicaid spending in Oklahoma by $42 million, according to projections from our state Medicaid agency.

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Medicaid back on the chopping block

by | April 7th, 2015 | Posted in Blog, Health Care, Healthcare | Comments (0)

chopping block

Photo by Eric Tastad used under a Creative Commons license.

As the Oklahoma Legislature enters the final months of session, state agencies and the populations they serve are bracing for another round of painful budget cuts. A stark example of the high stakes involved in this year’s budget shortfall is the state’s Medicaid program, which provides health care to over 800,000 low-income children, pregnant women, seniors, and persons with disabilities. There is no plausible scenario under which Medicaid will avoid cuts. But unless legislators are willing to take action to boost revenues substantially, the cuts to Medicaid providers, and the impact on the people they serve, could be enormous.

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Kansas is considering expanding health coverage. Oklahoma should, too.

by | March 25th, 2015 | Posted in Healthcare | Comments (0)
Photo by  Theophilos Papadopoulos used under a Creative Commons license.

Photo by Theophilos Papadopoulos used under a Creative Commons license.

It’s no secret that Kansas’s budget is in crisis. Following years of tax cuts and fiscal mismanagement, the state finds itself in a $600 million budget shortfall. The state is scrambling to fill the gap, including across-the-board budget reductions and further cuts to public schools that the Kansas Supreme Court has already ruled are constitutionally underfunded.

If you think this sounds familiar, you’re right. Oklahoma is in a similar situation – a $611 million budget hole, agencies facing devastating budget cuts, and a public education system badly in need of an infusion of funds.

However, unlike Oklahoma, Governor Brownback and the Kansas legislature are showing signs of being willing to consider the full range of options available to them. This includes boosting the state budget by working with the federal government to expand health coverage to the state’s low-income uninsured.

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