Millions of Americans gained access to health coverage in 2014 when big parts of the Affordable Care Act kicked in – but the health law’s effects were always muted in Oklahoma. When Oklahoma policymakers declined to accept federal funds to expand Medicaid to low-income Oklahomans, they stranded thousands of Oklahomans without access to health coverage. The effects of this decision disproportionately harm rural Oklahomans, their families and communities. Fortunately, it’s not too late to reverse course and expand Medicaid, bringing health coverage to the Oklahomans who need it.

Thousands of Oklahoma families are able to see a doctor or fill a prescription because of the state’s Medicaid program, SoonerCare. But instead of working to strengthen this proven, cost-effective program, Oklahoma is asking the federal government for permission to cut off Oklahoma parents and caretakers who don’t report working enough hours every week. SoonerCare was built to ensure that low-income families get essential health care, not to punish families for losing a job or missing some paperwork. The state’s new proposal is unworkable and should be withdrawn.

The proposal creates serious problems for Oklahoma families, with or without jobs. Most non-elderly adult Medicaid enrollees work, but they have low-wage jobs that generally do not offer health insurance and are often unstable, with frequent job losses and work hours that can fluctuate sharply from month to month. As a result, many working parents would be at risk of losing coverage for one or more months under this proposal.

For Oklahoma families to prosper, they must be able to take advantage of work and educational opportunities. But working or doing well in school is much, much harder without consistent access to health care. SoonerCare, Oklahoma’s Medicaid program, provides that needed care for more than one million low-income Oklahomans every year, two in three of whom are children. SoonerCare is an effective, efficient system that is funded by a combination of state and federal dollars. This year, Oklahoma was able to reverse a years-long trend of cuts and increase the rates paid by SoonerCare to doctors and other care providers. After this spring’s legislative sessions, the state’s key health care agencies were able to reverse a years-long trend and increase payments to care providers. These rate increases were possible in part because Oklahoma’s federal Medicaid funding is increasing.

Earlier this month, Gov. Fallin signed HB 2932, directing the state to apply for federal permission to be allowed to remove low-income parents from health care coverage for failing to work enough hours in a given week. This comes on the heels of an executive order the Governor signed in March directing the state Medicaid agency, the Oklahoma Health Care Authority, to explore such a waiver.

We’ve warned before of the pitfalls of implementing a work requirement for SoonerCare coverage. However, with Oklahoma now committed to developing such a proposal, it is vitally important that policymakers proceed with caution. A work requirement in Oklahoma will affect tens of thousands of struggling parents, as well as their children and families. Furthermore, no other state has yet implemented such a requirement, and the Medicaid programs of states whose plans have been approved differ significantly from Oklahoma’s. Oklahoma administrators will need to tread very carefully to ensure that Oklahoma does not create more barriers to health and employment in implementing their work requirement.

Last week, the Oklahoma legislature adjourned one of the more extraordinary legislative sessions in recent memory – one that followed one special session, ran partially concurrently with another, included nine days of protests at the Capitol, saw the Legislature raise revenues for the first time in nearly 30 years, witnessed a first step in criminal justice reform after years of efforts, and resulted in the largest funding bill in state history (although not if adjusted for inflation). But in all of the confusion and breaking news, it was easy to miss other developments. In the posts below, brief summaries by issue area lay out the major victories and defeats of this spring’s legislative session.

For years, we’ve advocated expanding access to health coverage for low-income adults in Oklahoma. More than 30 states have done so, and in the process have dropped their uninsured rates, increased access to needed care, and pulled rural hospitals onto better footing. However, this year Oklahoma legislators seem determined to move in the opposite direction, pushing for radical new restrictions to the state’s basic health coverage program for low-income adults. That’s exactly the wrong thing to do. Here’s why.

The cliché exists for a reason: breakfast really is the most important meal of the day. Its benefits are well-documented, especially for children. However, 1 in 5 Oklahoma children may not have consistent access to breakfast, jeopardizing their growth and ability to learn. For these children, school breakfast can be a lifeline.

Unfortunately, school breakfast participation trails school lunch participation in Oklahoma. Just 58 percent of Oklahoma students who had school lunches also had school breakfast in the 2016-2017 school year, according to a new report from Hunger Free Oklahoma. This represents a missed opportunity to help thousands of Oklahoma students get the nutrition they need, especially since providing those meals would come with more than $17 million additional federal dollars.

Fortunately, as the report outlines, Oklahoma schools can increase breakfast participation, including by moving breakfast into the classroom and by serving free breakfast (and lunch) to all students through the Community Eligibility Provision.

This post is the third in a series highlighting key bills in several issues areas that we’re following. Previous posts looked at legislation affecting economic opportunity for Oklahoma families and legislation to reform our criminal justice system.

A greater share of Oklahomans are uninsured than almost any other state, and our comparatively poor health has serious economic consequences. One might hope that Oklahoma’s legislators would be working this session to make sure more Oklahomans, not fewer, have access to health care. Unfortunately, some lawmakers have instead filed bills that would yank health coverage from low-income parents  and repeat failed experiments of the past. 

In The Know is your daily briefing on Oklahoma policy-related news. Inclusion of a story does not necessarily mean endorsement by the Oklahoma Policy Institute. Click here to subscribe to In The Know and see past editions.

Today In The News

Legislative Committees To Take Up ‘Step Up Oklahoma’ Plan: State lawmakers are expected to pass a series of bills in committee Thursday, that would raise taxes and give teachers $5,000 annual pay raises. There are bills to increase taxes on wind energy and coal production. Income taxes will be impacted by another bill, and yet another bill will raise the taxes on tobacco. That was a sticking point in last year’s budget negotiations [News9]. State worker pay raise would help Step Up chances, group says [NewsOK]. Sooner Poll shows Step Up Oklahoma support, wind tax omitted [NonDoc]. Step Up Oklahoma plan adds to the consensus that new revenues are essential [OK Policy].

Business-Backed Plan to Increase Taxes Gets Broad OK From Oil Groups After Expanding Discount: After getting concessions, a group of small independent oil and gas producers is now endorsing a suite of tax increases and government reforms written by a group of business leaders known as the Step Up Oklahoma plan. The plan calls for a 4 percent tax for the first three years of production. At first, many vertical well producers opposed this idea and backed State Question 795, which would ask voters to end all discounts and restore the standard 7 percent rate [StateImpact Oklahoma].

Step Up coalition’s new tax credit is a poor substitute for restoring the EITC: Just a few weeks ago, the Step Up Oklahoma coalition announced their plan for a variety of tax increases and reforms to resolve some of Oklahoma’s long-standing budget problems. Since then, the proposal has attracted support from a broad range of groups representing different parts of Oklahoma’s private and public sectors, and House leaders have promised that they will vote quickly on the package [OK Policy].

In The Know is your daily briefing on Oklahoma policy-related news. Inclusion of a story does not necessarily mean endorsement by the Oklahoma Policy Institute. Click here to subscribe to In The Know and see past editions.

Today In The News

Health Department’s recovery ‘tainted,’ CFO says in resignation: Oklahoma State Department of Health Chief Financial Officer Michael Romero has resigned, citing conflicts of interest with the new management’s handling of state and federal investigations. In his resignation letter, Romero said he drafted a memo on Wednesday to interim Health Commissioner Preston Doerflinger highlighting possible issues with implementing corrective actions in the wake of the agency’s public finance scandal [NewsOK].

Educators Say Legislation On Spending Flexibility Could Increase School Inequality: Oklahoma lawmakers have butted heads for years over how to increase funding for education, but one recurring idea has been to give schools more flexibility in spending the money they already have. A new bill filed by Sen. Josh Brecheen, R-Coalgate, is the most recent attempt to do this. Senate Bill 887 would allow schools to spend the money in their building fund on anything they want including books, classroom supplies, and teacher salaries [Oklahoma Watch]. Another year goes by, and Oklahoma still leads the nation for cuts to education [OK Policy].

‘I wasn’t supposed to be here’: Allison Ikley-Freeman sworn into state Senate seat: Sen. Allison Ikley-Freeman was still a little amazed that she was taking the oath of office Thursday to join the Oklahoma Legislature. “I wasn’t supposed to be here,” the 26-year-old Tulsa Democrat said. “You look at who typically becomes a senator and it was definitely not me.” Ikley-Freeman said she grew up in poverty that stretched for at least three generations [Tulsa World].