Earlier this year, we warned that Oklahoma risked deep cuts to our state’s health care safety net if we didn’t increase state funding for Medicaid and mental health services. The Oklahoma Health Care Authority, which administers Medicaid, needed $90 million and the Department of the Mental Health and Substance Abuse Services needed $20.9 million in new funding just to maintain existing services.
Instead, lawmakers budgeted flat funding for the Health Care Authority and just $2.2 million in new funding for mental health. As a result, Oklahoma has slashed Medicaid doctor reimbursements, hiked copayments for Medicaid patients, and reduced eligibility for services. Families who stand to lose behavioral health rehabilitation services have spoken out about the cuts. In response, Governor Fallin responded with a statement blaming President Obama. Governor Fallin’s spokesman Alex Weintz said:
Where the Department of Mental Health (as well as the Department of Human Services) did lose funding, however, was in the form of federal FMAP funds. Unfortunately, President Obama’s decision to cut Oklahoma’s FMAP funds may reduce services in mental health as well as health services for poor Oklahomans.
Yet President Obama does not control Oklahoma’s FMAP funds. The FMAP, or Federal Medical Assistance Percentage, is a formula that determines federal contributions to state Medicaid programs. The mechanism governing the FMAP has been the same since 1965, long before the Affordable Care Act or any other changes under President Obama. Instead, the recent decrease in FMAP funds for Oklahoma is entirely due to a sprightly state economy.
FMAP matching funds for states are based on a formula that compares state per capita income to the national average. California, which has a relatively high per capita income, has a 50 percent match rate; Mississippi, which has a relatively low per capita income, has a 73.58 percent match. When state economies improve and per capita incomes rise, the FMAP formula assumes that the state is less in need of federal assistance and drops the matching rate accordingly. That’s why Oklahoma’s matching funds for Medicaid dropped from 64.02 percent to 62.30 percent this year.
Oklahoma’s economy is doing well. The reason we are cutting services for some of our most vulnerable families, even during these good economic times, has nothing to do with President Obama and everything to do with Oklahoma leaders’ mismanagement of the state budget.
The federal government assumes Oklahoma has the resources to take care of our own – but we aren’t doing it. Instead, we’re failing to plan for the future, extending unnecessary tax breaks, approving unwise tax cuts, and refusing federal funds that would dramatically improve health coverage for low-income Oklahomans.
The President no doubt makes for an attractive scapegoat. Unfortunately, this is a catastrophe that can’t be blamed elsewhere.