Bill Watch: Legislation threatens to cut Oklahomans’ access to health care

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. 

Yanking health coverage for losing a job

Oklahoma’s health insurance system for low-income families overwhelmingly serves people who have no other options – children, elderly adults, and people with disabilities. Just 1 in 10 SoonerCare members are working-age adults without an official determination of disability. To qualify for SoonerCare, they have to be parents or caretakers of dependent children, and they have to make very, very low-incomes – a single mother with one child is too wealthy to get coverage through SoonerCare if she earns more than $625 per month. 

Families living on incomes this meager are doing everything they can just to get by, but several bills filed this session would seriously jeopardize parents’ access to health care. HB 2932*, SB 1179, SB 1210 and SB 1575 would allow the state to terminate these parents’ health coverage if they don’t work a required number of hours or participate in a state-approved work or volunteer program. But most SoonerCare patients who can work, already do – and those that don’t have serious barriers to employment that are not fixed by these bills, such as caregiving responsibilities for a child or aging parent. Furthermore, dropping coverage for an inhaler or ADHD medication will only make people less employable. Oklahoma lawmakers shouldn’t be making it harder to be healthy, and legislators should reject these bills.

Constricting eligibility for basic health care

The efforts to take health coverage from low-income parents don’t stop there. Parents already have to be extraordinarily poor to qualify for SoonerCare, but SB 1030 would push the income eligibility cutoff even lower: a single mother with one child would be too wealthy to qualify if she made just $300 per month. This would make SoonerCare one of the most restrictive Medicaid programs in the country, and it would take health coverage away from thousands of parents. Another bill would go further: HB 3344 would end coverage for these parents entirely, something no state has ever done.  

Repeating failed experiments

SoonerCare is an effective, efficient health program, with low administrative costs and lower cost growth than private coverage. So it’s odd that legislators would seek to upend this success by privatizing the program, but that’s what SB 1285 and SB 1331 would seek to do.  It’s especially odd given that privatized Medicaid coverage in Oklahoma has already failed – and a majority of both the House and the Senate signed onto a resolution to stop a similar attempt last year. If lawmakers want to make coverage more efficient, they should expand on the success of the existing SoonerCare system rather than attempt a radical overhaul. 

On a similar note, SB 1418 would require the state Department of Human Services (DHS) to privatize their process for determining who does and doesn’t qualify for SoonerCare. DHS handles SoonerCare enrollment for individuals with complex disabilities. Other states have found that when access to care for people with disabilities is left up to private companies, needed care is cut in the name of saving money. Lawmakers should look elsewhere for savings.

The bottom line

After years of budget shortfalls, lawmakers may be tempted to blame to programs like SoonerCare and the families who need it as the cause of the state’s financial woes. It’s true that Oklahoma’s spending on health care has been growing, but that has been in response to need in a state that still has one of the highest uninsured rates in the nation.

 In the long run, we know that a healthier state is a more productive, economically prosperous state. If lawmakers really want to reduce the cost of covering Oklahoma’s poorest families, they should be focused on policies to make the economy work better for all and using all available federal dollars to expand health coverage. If they instead focus on taking away health care from struggling parents, they will only make our state’s economic future worse.

* HB 2932 currently instructs the Health Care Authority to eliminate coverage for low-income parents, but the bill’s author has said he plans to file new language imposing work requirements