Medicaid proves its worth

Extending health coverage to more uninsured people through Medicaid is at the core of the Affordable Care Act’s efforts to ensure access to affordable health insurance for millions of Americans.  Currently in Oklahoma, nearly fifty per cent of low-income adults under age 65 lack health insurance. Working-age Oklahomans are now eligible for Medicaid only if they are parents of dependent children and have annual income less than around $6,000.

Covering this population through Medicaid would provide substantial economic benefits to Oklahoma, saving the state millions of dollars that now go to cover the cost of caring for those without insurance, creating new jobs in health care and related fields, and generating significant new tax revenues.  The vast bulk of the cost –over 90 percent – would be assumed by the federal government, which would spend over $12 for every state dollar from 2013 to 2022. 

Despite these compelling benefits, some assert that Oklahoma would be better off not expanding Medicaid.  Critics typically claim that Medicaid is an “outdated program” and “a broken system that isn’t good for the care providers or the recipients.”

In a new OK Policy issue brief, we show that Oklahoma’s Medicaid program, SoonerCare, is far from broken.  It is, instead, an indispensable cornerstone of the state’s health care system, providing affordable, efficient care to hundreds of thousands of low-income children, expecting mothers, seniors, and persons with disabilities. Oklahoma’s Medicaid program has proven its worth in many ways:

• Medicaid is a cost-effective health insurance program. Medicaid costs have risen at a more modest pace than total health expenditures or premiums for employer-sponsored coverage (see chart). Per capita costs for Medicaid patients are significantly below those for patients covered by private insurance, after adjusting for enrollees’ health differences. Oklahoma’s Medicaid costs are well below the national average.
• Medicaid recipients have access to a broad-based provider network. There are over 34,000 medical providers with a SoonerCare contract. The program’s network of primary care physicians has the capacity to serve more than twice as many SoonerCare patients as are currently enrolled in the program;
• Medicaid pays providers fairly and competitively. Oklahoma’s provider rates are among the nation’s highest.  Most doctors are paid at 96.5 percent of Medicare rates, while those affiliated with the state’s medical schools are reimbursed at over 140 percent of Medicare rates. Assessments levied on providers have boosted reimbursements for hospitals, nursing homes, and care facilities for individuals with developmental disabilities.
• Medicaid patients are satisfied with the service. Surveys of Oklahoma Medicaid patients consistently show high levels of satisfaction with their care. Among adult SoonerCare patients, 91 percent rated their satisfaction with the program as “above average”
• Oklahoma’s Medicaid program has developed high-quality, cost-effective programs.  Oklahoma has implemented a number of programs in recent years to improve the quality of care and service for Medicaid patients and to reward providers for better, more cost-effective care. Oklahoma’s online eligibility and enrollment system is one of the most advanced in the nation. A recent article in the national journal Health Affairs  stated, “when it comes to enrolling its citizens in Medicaid, Oklahoma is a shining example of how to do things right” and suggested that other states learn “from the vision and transparency of Oklahoma’s leaders.” 
• Medicaid coverage leads to better health outcomes. Recent research has convincingly established that Medicaid provides wide-ranging benefits in terms of access to health care, physical and mental health outcomes, and the financial stability of families.

Medicaid has proven its worth and is improving lives in Oklahoma every day.  Extending the program to low-income adults would provide clear and compelling benefit to the state and its citizens.

Click here to download the full 13-page issue brief or the 2-page summary. For a full array of resources and materials on Medicaid and the Affordable Care Act, click here.