OKPOLICY.ORG
The governor’s office this week released its first DOGE-OK report to promote government efficiency at the state level, mimicking the aims of the federal effort being led by Elon Musk. The DOGE-OK report identified $157 million in “wasteful” health care grants.
Statement from OK Policy Executive Director Shiloh Kantz:
“Taxpayer dollars should be spent wisely, but cutting health care funds is both counterproductive and harmful. Oklahoma already ranks among the worst in health outcomes – cutting dollars that could be used to improve public health will only shift these costs elsewhere. Short-term savings will lead to far greater costs in the future, both in dollars and lives.”
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Additional points to consider
- Oklahoma spent about $33 billion last year – this includes both appropriated revenue (about $12 billion) and non-appropriated revenue that is outside of legislative spending.
- The $157 million identified in the DOGE-OK report is less than one-half of a percent of Oklahoma’s spending last year – and about 1% of appropriated revenue
- There appear to be only three areas for recommendations: health care, higher education, and state workforce numbers. This doesn’t seem nearly as comprehensive as it was sold to be. And the issue areas of public health and education are places that need investment right now, not cuts.
Health Care
Much of this report is focused on health care issues, which should remain a point of emphasis for Oklahoma given the state’s poor outcomes.
- Oklahoma ranked 45th for children’s health (KIDS COUNT 2024)
- Oklahoma ranked 47th for health in 2024 (America’s Health Rankings)
The report suggests returning 33% ($132 million) of unspent money from an eight-year grant for Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases.
- The timing of this recommendation seems concerning given the rising numbers of measles cases and whooping cough at the moment.
- It also seems incongruous considering the issues the state has experienced with its state public health lab and pandemic center.
Federal, not state issues
Many of the recommended actions in the health care section are outside of the scope of state decision makers; they require federal action:
- Repeal federal continuous coverage requirement to allow states to perform regular eligibility checks for children.
- Repeal federal requirement for states to cover prescription drugs in accelerated approval program.
- Repeal CMS minimum staffing requirements rule for long-term care facilities.
These requirements exist to ensure that states are meeting the necessary care for its residents.
- The proposal to remove the continuous coverage requirements for children is especially alarming.
- For more reading on the importance and benefits of continuous health care, read: Continuous Eligibility Keeps People Insured and Reduces Costs from the Center on Budget and Policy Priorities.
- Ensuring that our children have continuous care better helps them stay safe and healthy. Lapses in coverage are harmful, especially to this vulnerable population.
- It also doesn’t address whether Oklahoma children are able to see the medical specialists that their health requires within our state borders.
- And for anyone who has a loved one in long-term care facilities, they should ask themselves: Do I think that my loved one’s long-term care facility is currently overstaffed?
Spending controls
The report itself passingly mentions spending controls, but doesn’t adequately address how the state can better ensure taxpayer dollars are not misused. As a reminder, here are a few examples of spending that has been publicly questioned:
- The state bought $2.6 million of hydroxychloroquine in the first days of the COVID pandemic.
- Millions of pandemic relief was spent on Christmas trees, gaming consoles and hundreds of TVs. The state auditor found millions of federal dollars were spent incorrectly.
- The state is trying to claw back $5 million in private school tax credits from 1,855 Oklahoma taxpayers for students who did not attend participating private schools for the entire period for which the tax credit was approved.
- A Tulsa World examination also found dozens of out-of-state schools registered for Oklahoma’s private school tax credit – from as far away as California, Idaho, Ohio, Florida and even Japan. But the Oklahoma Tax Commission hasn’t said how much of the $150 million allocated for tax year 2024 have ended up in out-of-state school coffers.
- A 15-year project plan from the Oklahoma Turnpike Authority is $3 billion over budget.
