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What’s up this week at Oklahoma Policy Institute? The Weekly Wonk shares our most recent publications and other resources to help you stay informed about Oklahoma. Numbers of the Day and Policy Notes are from our daily news briefing, In The Know. Click here to subscribe to In The Know.
This Week from OK Policy
CDC eviction moratorium will help, but Oklahoma’s housing crisis still looms large: The economic devastation brought by the COVID-19 emergency has put millions of Americans on the brink of financial ruin and homelessness. In Oklahoma, nearly half of adults believe they are likely to be evicted or foreclosed upon in the next two months. Statewide, nearly 14,000 evictions have been filed, and nearly 6,000 granted, since Gov. Stitt declared a state of emergency on March 15. Data show that eviction filings and orders have accelerated in Oklahoma even after the Centers for Disease Control issued an eviction moratorium that took effect on Sept. 4, and Oklahomans remain at risk for eviction through the end of the year. State and court officials must do more to ensure that people covered by the CDC moratorium are not evicted, but robust federal economic support to families is the only way to avoid a major crisis in the coming months. [Ryan Gentzler / OK Policy]
Battle brewing over managed care in Oklahoma: There is a big battle brewing over Medicaid managed care in Oklahoma that will play out during the next Legislative session. It is no wonder. With what legislators say was little or no consultation, the Oklahoma Healthcare Authority (OHCA), at Gov. Kevin Stitt’s direction, issued a Request for Proposal (RFP) to private health care companies to submit bids to manage the state’s Medicaid program. Health care companies have been lobbying the Legislature, without success, for several years to adopt managed care. The Governor moved ahead with the RFP while the Legislature is out of session, and OHCA Director Kevin Corbett said the selection of the managed care contractors will be announced in early February, just as the legislature is returning to session. [Steve Lewis / Capitol Update]
Policy Matters: SQ 814 isn’t only path to fund Medicaid expansion: In June, Oklahoma voters approved expanding Medicaid to provide health care coverage for many low-income Oklahomans. The mechanism to pay for it, however, was left open-ended for our elected officials. While State Question 814 provides one possible option, it is far from the only one. Lawmakers have an array of alternatives that would both fully fund expansion and help address other crucial state needs. [Ahniwake Rose / OK Policy]
Weekly What’s That
Managed Care
Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Unlike a traditional fee-for-service system, in which a provider is paid directly by an insurer for every service delivered, under managed care, an organization or provider is responsible for providing a specified set of services for each insured member in return for a set monthly payment, known as the capitation rate.
A managed care organization is an entity that receives a capitated payment and coordinates a patient’s care through a defined network of physicians and hospitals. An HMO, or Health Maintenance Organization, is a variety of managed care organization that typically requires patient to seek care from doctors and other providers who work for or contract with the HMO. In exchange for being limited in their choice of providers, patients enrolled in an HMO typically have lower out-of-pocket costs than in a fee-for-service plan.
Oklahoma’s Medicaid program, known as SoonerCare, operates a limited form of managed care. Under the SoonerCare Choice program, most children and working-age adults select or are assigned to a Primary Care Provider/Care Manager (PCP/CM), who receives a monthly capitated payment for coordinating the care of each of their patients. Oklahoma ran a fully capitated managed care HMO program in urban areas from 1996 to 2004.
Look up more key terms to understand Oklahoma politics and government here.
Quote of the Week
“These are really extraordinary times. The need to connect people with health coverage is critically important right now.”
-Jesse Cross-Call, senior policy analyst at the Center on Budget and Policy Priorities [The Nation]
Editorial of the Week
Pandemic exposes shortfalls of health care system
COVID-19 and the novel coronavirus that causes the highly contagious respiratory disease pulled back the curtains on a health care system woefully unprepared for this pandemic.
The pandemic exposed the shortcomings of a health care system motivated by profits rather than patient and public health outcomes. The profit-motive system ensured minimum staffing levels, minimum bed capacities and the limited availability of personal protective gear when COVID-19 hospitalizations first peaked in April.
Hospitals in the heartland weathered the first peak as a result of state emergency orders that prohibited the delivery of nonessential health care. Those hospitals were unable to escape a second surge of new cases that peaked in July as the novel coronavirus spread throughout southern states and into rural areas.
Americans moved indoors with the arrival of autumn and flu season, and a third surge of COVID-19 cases that predictably began after a reckless weekend of Labor Day festivities fueled record high numbers of patients requiring hospitalization. The COVID Tracking Project shows hospitalizations related to COVID-19 patients began rising from 499 on Sept. 14 and has climbed since then to 870 on Wednesday.
Numbers of the Day
- 263,000 – Number of Oklahoman expected to gain health care coverage following vote to expand Medicaid.
- 8.6% – Percentage of uninsured children in Oklahoma, which is the nation’s fifth highest rate. The national children’s uninsured average is 5.7%.
- 13.8% – Percentage of American Indian/Alaska Native children without insurance nationally (2019).
- 92,126 – Number of Oklahomans who enrolled in Medicaid from February to July 2020.
- 79.6% – Percent of children under age 3 in Oklahoma living in metro areas. Nationally, 91.6% live in metro areas.
See previous Numbers of the Day and sources here.
What We’re Reading
- Children’s Uninsured Rate Rises by Largest Annual Jump in More Than a Decade [Georgetown University for Children and Families]
- Missouri, Oklahoma Should Quickly Implement Medicaid Expansion Amid COVID-19 [Center on Budget and Policy Priorities]
- State Medicaid Programs Respond to Meet COVID-19 Challenges [Kaiser Family Foundation]
- Loss of the Affordable Care Act Would Widen Racial Disparities in Health Coverage [Kaiser Family Foundation]
- COVID-19 and student performance, equity, and U.S. education policy [Economic Policy Institute]
