Weekly Wonk: Fines & fees hurt rural Oklahomans | Are Medicaid patients overusing the ER? | HB 1775 would whitewash history

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’s edition of The Weekly Wonk was published with contributions from Communications Intern Lilly Strom.

This Week from OK Policy

Rural Oklahomans frequently carry larger burden for court fines, fees: Data from the Oklahoma Policy Institute’s Open Justice Oklahoma database, which draws from state court records, shows that fines and fees are harming Oklahomans statewide, with rural Oklahomans particularly impacted. Our analysis suggests that rural Oklahomans are asked to pay just as much, and often more, than their urban counterparts. More worrisome still, urban areas like Tulsa and Oklahoma counties have the most difficulty in collecting fines and fees, meaning rural Oklahomans are effectively contributing more of their money to fund the court system as compared to their urban counterparts. Far from being a uniquely “urban” issue, excessive court fees and fines are a statewide problem, and one that demands a statewide solution. [Andrew Bell / OK Policy]

Are Medicaid patients overusing the ER? As part of a larger pattern of demonizing the social safety net, critics of the Medicaid program frequently claim that patients overuse emergency rooms for non-emergency care and that the state must address this problem to contain Medicaid spending. However, there is little evidence to support this claim. In reality, Oklahoma’s SoonerCare enrollees use the emergency room at rates comparable to the general population, and emergency services represent a small fraction of total SoonerCare expenditures. Legislators concerned about rising health care costs should worry less about the health care practices of individual SoonerCare members and more about how we can most effectively provide health care for all Oklahomans through the SoonerCare program. [Emma Morris / OK Policy]

Op-ed: Follow through on SQ 781 by funding treatment and rehabilitation services: Oklahoma has made remarkable progress to reduce our incarceration rate in recent years. Reforms through the ballot box, reforms by the Legislature and administrative efforts have contributed to a consistent decline in our prison population and a reduction in felony charges across the state. In 2016, Oklahoma voters approved two of the biggest criminal justice reform measures in state history: SQ 780 and SQ 781. [Ryan Gentzler / NonDoc]

Policy Matters: HB 1775 would whitewash our history: Our national and state history is littered with dark stains stemming from racial inequities ingrained in our economic, political and legal systems. House Bill 1775, which now sits on Gov. Kevin Stitt’s desk for signature, would direct Oklahoma educators to turn a blind eye to the historical events that led us to this place and keep us from fully exploring the paths that move us away from these inequities. If signed into law, HB 1775 would prevent public schools and universities from fully teaching about the inequality and racism threaded throughout our history and public systems. It would have a chilling effect on teachers wanting to examine atrocities like the Trail of Tears and the Tulsa Race Massacre, events that influence the daily lives of Oklahomans. It also would ban mandatory gender or sexual diversity training or counseling. [Ahniwake Rose / Journal Record]

New law seeks to improve health education in schools (Capitol Update): Despite all the hoopla this session over the many politically charged bills dealing with wedge issues, there has been some truly positive legislation passed by thoughtful legislators. One of those signed by Gov. Stitt last week is Senate Bill 89, to be known as the “Health Education Act,” by Sen. John Haste, R-Broken Arrow, and Rep. Rhonda Baker, R-Yukon. [Steve Lewis / Capitol Update]

Weekly What’s That

Emergency Rules

Emergency rules are exceptions to the regular permanent administrative rule-making process for state agencies, boards and commissions. As set out by Title 75, Section 253 of Oklahoma Statutes, emergency rules may be promulgated if an agency can establish that the rule is required to:

a. protect the public health, safety or welfare,

b. comply with deadlines in amendments to an agency’s governing law or federal programs,

c. avoid violation of federal law or regulation or other state law,

d. avoid imminent reduction to the agency’s budget, or

e. avoid serious prejudice to the public interest.

The Governor has 45 days to approve or reject an emergency rule request. If the Governor approves a rule, it takes immediate effect and remains in effect until the first day of the next legislative session, or no later than September 15th if in effect during the legislative session. Emergency rules can be disapproved by the Legislature or superseded by the promulgation of permanent rules.

Agencies may not establish or raise fees by emergency rule while the Legislature is not in session, with limited exceptions.

Look up more key terms to understand Oklahoma politics and government here.

Quote of the Week

“I think the development of (HB 1775) is done without the input, one, of educators and, two, of people of color. People of color are not asking for anything other than empathy, and you can’t understand our story if we can’t share it.”

-Cecilia Robinson-Woods, superintendent of Millwood Public Schools, speaking out against HB 1775, which would limit teaching on race-related issues [The Oklahoman]

Editorial of the Week

OUR VIEW: Managed Care is a Gamble

We like to see all of the arguments for and against privatized managed care for Medicaid in Oklahoma.

We’ve seen plenty against managed care, which suggests it would lead to rationing care, larger overhead and worse patient outcomes.

Gov. Kevin Stitt’s main argument for managed care is that Oklahoma currently ranks low and this would make us better.

We don’t get a lot of the “how” it’s supposed to be better.

In a December op/ed Stanley Hupfeld, former President and CEO of Integris Hospital and chair of the Oklahoma Health Care Authority Board wrote:

“These entities will accept a negotiated fixed premium at the beginning of the care cycle. In exchange they will deliver all the care the recipient requires. If they can do this and keep the population healthy, they will profit. If they cannot, they will suffer a loss. The concept is to focus on being proactive in indemnifying that recipients stay healthy and reduce the requirement to use the most expensive parts of the health care system.”

So, the idea is that the insurance company is “on the hook” for care even if it gets really expensive to treat a patient.

One more time:

“In exchange they will deliver all the care the recipient requires.”

When has that ever been the case for health insurance, private or otherwise?

We’ve also seen the argument, and it’s usually a fair point, “well of course pharmacists and health unions are against privatized care because it affects their bottom line.”

But, sure, let’s think about it from strictly who stands to make money.

Would you rather have your local pharmacy and hospital be financially well off, or would you rather that money pad the pockets of out-of-state insurance companies?

Why is this a discussion?

Why not see what expanded Medicaid does for the state first before fiddling with it?

How might that change our rankings?

Oklahomans aren’t poker chips, so let’s not gamble with our health.

[Stillwater News Press]

Numbers of the Day

  • 33% – The percentage of statewide criminal court debt collected through fines and fees in a given year. The majority of court debt goes uncollected ever year, revealing a deeply inefficient collections system. [Oklahoma Policy Institute]
  • 42,176 – The number of Oklahoma driver’s license suspensions issued for Failure to Pay / Failure to Appear in 2018 [Free to Drive]
  • $27 million – The amount that total court fine and fee assessments grew between 2012 and 2018 [Oklahoma Policy Institute
  • ~28% – The percentage of people booked into the Tulsa Jail on court debt-related complaints in a typical year [Lawyer’s Committee for Civil Rights]
  • ~10-30% – The percentage of the district courts’ operating costs covered by the legislature’s appropriations in a typical year. The courts produce roughly 70-90% of their own funding each year, leading to a reliance on fines and fees for funding. [Tulsa World]

What We’re Reading


David Hamby has more than 25 years of experience as an award-winning communicator, including overseeing communication programs for Oklahoma higher education institutions and other organizations. Before joining OK Policy, he was director of public relations for Rogers State University where he managed the school’s external communication programs and served as a member of the president’s leadership team. He served in a similar communications role for five years at the University of Tulsa. He also has worked in communications roles at Oklahoma State University and the Fort Smith Chamber of Commerce in Arkansas. He joined OK Policy in October 2019.

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