COVID-19 Policy Analysis: As our nation confronts the COVID-19 pandemic, OK Policy will be analyzing state and federal policies that impact our state and its residents during this national health emergency. These posts reflect the most current information available at publication, and we will update or publish follow-ups as new information becomes available.
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Recent events have made glaringly apparent how public health and economic crisis are inseparable. Policymakers must prioritize access to health care, particularly for the low-income Oklahomans most likely to be facing serious economic hardship in the coming weeks and months. To that end, there are many things the state can do to address the issues, but here are three actions state policymakers must immediately take:
Seek full Medicaid expansion as quickly as possible
Gov. Stitt’s alternative expansion plan already calls for one year of full Medicaid expansion beginning July 1. Lawmakers should seek to accelerate that timeline by implementing expansion as soon as possible. During a March 18 virtual public meeting about the governor’s health care proposal, an Oklahoma Health Care Authority (OHCA) official said this was possible with legislative action if the Oklahoma Legislature acted to fund it.
More than 200,000 Oklahomans currently do not have access to health care because they work in jobs that do not offer benefits. With joblessness numbers skyrocketing in Oklahoma and nationwide, that figure will only grow significantly. Rather than wait until July, legislators should act as soon as possible to ensure that Oklahomans can access the health care services they need.
Stop current efforts to limit Medicaid expansion
In Gov. Stitt’s alternative expansion proposal, full Medicaid expansion will begin on July 1 and last for one year. His proposal includes a second stage, pending federal approval, that would see Oklahoma begin enforcing a battery of measures that will keep Oklahomans from getting the care they need. These restrictive requirements would begin effective July 1, 2021. The second stage of his plan is currently posted on the state Medicaid agency website and is available for public comment through April 15.
Oklahoma should stop this effort immediately. The state’s Medicaid agency is already scrambling to respond to the current public health crisis and should not be forced to redirect attention and resources to a dubious effort to restrict health care access more than a year from now.
In addition, the 30-day public comment phase is an essential avenue for the public to learn about this plan and offer feedback, especially given that the plan developed was behind the scenes with no opportunity for public or Legislative input. OHCA has listed one additional upcoming virtual public meetings regarding the waiver on March 24. (A March 30 hearing date was added to the site last week, but has since been removed. The link now notes this is for the OHCA Special Board Meeting on the same date.)
The online meeting tool for these public forums, however, requires broadband internet access to participate. Fully one-third of Oklahomans lack broadband internet access, and many of these residents are impacted by the coverage gap. It’s inherently unrepresentative for the state to proceed with a public hearings built on this platform.
Oklahomans cannot reasonably be expected to give this issue the full attention it deserves while the nation is in the grip of a pandemic. If the Governor directs OHCA to continue nonetheless, the agency must substantially extend the comment period in recognition of the weight of the issue and the considerable strain both they and the public are operating under, and further public meetings must allow participants to ask their questions directly.
Suspend agency consolidation efforts
In recent weeks, the state Legislature was moving full steam ahead with a bill that would dissolve the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) and transfer its responsibilities to the state’s Medicaid agency (the Oklahoma Health Care Authority, or OHCA). This effort should be suspended until it can be taken up with full attention.
The consolidation would move oversight of drug courts, provision of behavioral health services, and more into what is essentially a state-run health insurance agency. Oklahoma health care providers and patient advocates repeatedly have warned this agency consolidation would put patients and providers at serious risk. This would mean that Oklahomans would go without the care they needed and that medical facilities could close.
In addition, the bill calls for a full plan to consolidate the agencies by June 30 of this year. This hopelessly ambitious timeline would undoubtedly make a chaotic process even more so. During a national health emergency, this clearly is not the time to consider such disruptive action to Oklahoma’s health care agencies, especially since there is no pressing reason to consolidate at this moment. This effort should be suspended until policymakers and advocates can meaningfully engage and come to an agreement that best serves the needs of Oklahomans.