Governor should extend health care comment period as virtual ‘public hearings’ lack transparency, full representation

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.

NOTE: OK Policy is not a state agency and we cannot assist in applying for state services or provide legal advice.

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Whenever our governments propose sweeping change to how they operate, it’s incumbent upon them to act transparently and provide maximum opportunities for citizen input. Oklahoma’s ham-handed attempts to force through the Governor’s health care proposal fails in both regards. 

After months of talking about unveiling an Oklahoma health care plan, Gov. Stitt’s administration on March 16 finally unveiled his health proposal, which would provide restrictions on health care coverage for thousands of our friends and neighbors. This started the clock on a 30-day comment period for the state Medicaid agency (Oklahoma Health Care Authority) to allow Oklahomans the opportunity to review, ask questions, and comment on the proposal before the state submits it to federal regulators for review.

For Oklahomans to give this proposal careful and thoughtful attention, the timing couldn’t be worse to have this process occur as Oklahoma and the nation wrestles with an unprecedented pandemic. To date, the agency has held three of its scheduled virtual “public meetings” on the proposal. The OHCA has added a fourth virtual hearing on March 26. It’s unclear when this meeting was scheduled or what further meetings the agency plans to hold in the future.

By the last meeting on March 24, the process had somewhat improved, with questions visible as they were submitted and the state agency spokesperson no longer paraphrasing questions. However, even at their best, these virtual public meetings have not been smooth, with technical issues, users unable to connect, no opportunity to share statements, and no recordings of the proceedings available to attendees.

Also, agency officials have alluded that the pivot to all-digital hearings has taxed resources as agency staff are working remotely while they implement an entirely new public hearing model.  

Proposed changes to virtual public comment period

Despite the challenges of pivoting to virtual meetings, OHCA reports unprecedented participation, with more than 500 attendees in the first two meetings alone. However, as both attendees and OHCA struggled to adjust to the new format in the middle of a public health emergency, attendees still lost out on vital elements of in-person public meetings.  

To ensure that as many Oklahomans as possible have the opportunity to engage with the public comment period, here are actions that Gov. Stitt and the OHCA must do in order for this process to have full transparency and representation: 

  • Extend the comment period through the end of the national health emergency 
  • Hold at least 10 additional virtual public hearings 
  • Allow participants time to make short prepared statements during virtual public hearings
  • Make visible the number of attendees during virtual public hearings 
  • OHCA representatives must answer the question as written, not a paraphrase of the question, during virtual public hearings 
  • Representatives must respond to all unanswered questions, as written, by a date announced at the virtual public meeting
  • Release full recordings – audio and video – of virtual public hearings. 

Gov. Stitt should withdraw proposal, or extend comment period 

As Oklahomans are rightly turning their attention to our nation’s urgent health emergency, Gov. Stitt should withdraw his health care proposal, or at the very least, extend the comment period to allow as many Oklahomans to participate. 

Even in the best of times, 30-day comment periods are a rush. These are not the best of times. 

By withdrawing the proposal or extending the comment period, our government representatives can ensure that as many Oklahomans as possible have their voice heard. This proposal represents significant barriers to health care in our state, which has enormous ramifications on Oklahoma’s overall economic and physical well-being. 

Oklahoma has extended comment periods for health care proposals in the past. In 2018, OHCA sought federal approval to cut SoonerCare coverage for parents who didn’t meet a work requirement. At that time, the agency voluntarily doubled its 30-day comment period and held dozens of public hearings around the state. 

With his current proposal, Gov. Stitt is seeking much more dramatic changes to the state’s public health infrastructure at a time when the agency, health care advocates, and the public are understandably distracted by crisis elsewhere. OHCA has admitted to unprecedented participation in virtual public meetings despite manifold technical difficulties. In little over a week, more than 800 comments had been submitted as of March 24. Clearly, the public is interested; just as clearly, the current crisis does not allow the agency, advocates, patients, and providers to give this matter the full attention it deserves. 

There is no compelling reason for Gov. Stitt to require OHCA to proceed with this proposal now and on this timeline. If OHCA is not allowed to withdraw the proposal, it must move forward on the most transparent path possible per the recommendations above. 

Set an election date for SQ 802 

Finally, Gov. Stitt must respect the will of voters and set an election date for SQ 802. Last fall, a record number of Oklahomans signed the petition for SQ 802, which calls for a full Medicaid expansion. The approvals were in place by early January and the measure has been sitting on his desk for 76 days now. In the interim, he has rushed his own hastily assembled health care proposal through the bureaucratic process. 

Government transparency and accountability is especially crucial during a crisis. By not setting an election date for SQ 802, the Governor risks his own credibility with his constituents, and the belief of Oklahoma voters that their government truly represents them.

ABOUT THE AUTHOR

Carly Putnam joined OK Policy in 2013. As Policy Director, she supervises policy research and strategy. She previously worked as an OK Policy intern, and she was OK Policy's health care policy analyst through July 2020. She graduated from the University of Tulsa in 2013. As a student, she was a participant in the National Education for Women (N.E.W.) Leadership Institute and interned with Planned Parenthood. Carly is a graduate of the Oklahoma Center for Nonprofits Nonprofit Management Certification; the Oklahoma Developmental Disabilities Council’s Partners in Policymaking; The Mine, a social entrepreneurship fellowship in Tulsa; and Leadership Tulsa Class 62. She currently serves on the boards of Restore Hope Ministries and The Arc of Oklahoma. In her free time, she enjoys reading, cooking, and doing battle with her hundred year-old house.

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