Oklahoma Health Care Authority board leaders make tough choices over where to cut Medicaid services for some of the poorest residents (The Oklahoman)

By Jaclyn Cosgrove

The word “difficult” was used throughout Thursday’s board meeting of the state’s Medicaid agency, as leaders discussed millions of dollars in cuts that had to be made to balance the agency’s budget for the coming fiscal year.

During a standing-room only meeting, the Oklahoma Health Care Authority board voted Thursday on several changes, including changes in mental health services and increases in co-payments, that will affect some of Oklahoma’s poorest residents.

Leaders at the Oklahoma Health Care Authority, which administers Medicaid, said the agency faced a $104 million shortfall, in part, because of decreases in federal funding it receives and also because of less money in tobacco tax dollars.

Board chairman Ed McFall, a pharmacist from rural Oklahoma, said he encouraged several meeting attendees to contact their lawmakers and tell them what impact the budget cuts will have on them personally.

“If you don’t let them know these cuts are affecting your communities, next year’s budget decisions will likely be more of the same or even worse, and the solution of this problem is not right here at the Oklahoma Health Care Authority,” McFall said. “The solution of this problem lies at 23rd and Lincoln.”

Along with the budget cuts approved Thursday, the board is expected to meet Tuesday to discuss whether the agency will cut the rate it pays physicians and other medical providers for the services they deliver to Medicaid recipients. The measure was anticipated to be on the agenda Thursday but had to be removed to comply with Oklahoma’s Open Meetings Act.

One of the votes that the board members made was to increase how much Medicaid recipients pay in co-pays. Most co-pays will increase from $3 to $4, according to the health care authority.

David Blatt, the executive director of Oklahoma Policy Institute, said he was frustrated to be talking about budget cuts with leaders of an agency that could have received millions of dollars had Oklahoma expanded its Medicaid program, an option associated with the much-debated Affordable Care Act.

Blatt’s frustration was met with applause from the audience.

“This proposal to raise copayments … is the wrong choice,” Blatt said. “This directly affects the empty pocketbooks of Medicaid recipients. These are low-income parents, seniors, those with disabilities and chronic health conditions. Some are taking four to six medications a month. This is an extra $15 to $20 in cost, which many Medicaid recipients just don’t have.”

Rehabilitative services cut

The board also voted to change eligibility for adult and children Medicaid members who could receive psychosocial rehabilitative services, a cut that was made to save the Oklahoma Department of Mental Health and Substance Abuse Services about $20 million.

Under the new eligibility requirements, adults and children will not be covered for psychosocial rehab services, which include teaching life skills and coping, unless they have been hospitalized at a psychiatric inpatient facility; have been admitted to a crisis center; or have been determined disabled by the Social Security Administration for mental health reasons, among a few other caveats.

Former Sen. George Miller called Thursday’s proposed rule changes some of the toughest votes he had ever made, noting he was against every single change but felt he had no other options.

“I can’t help it,” Miller said. “Fiscal year starts on July 1. This is June 26. I used to have a vote in the Legislature, but I gave it up. I wish I still had it, but it wouldn’t have made any difference. But anyhow, I apologize, but I really don’t have an answer.”



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