Weekly Wonk: Session wrap up for health issues, working families | Expansion numbers encouraging | What’s next for managed care?

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

• The 2021 session proved a mixed bag for health issues: Oklahomans across the state will soon be able to more easily visit a doctor or fill a prescription, thanks to voter approval of State Question 802 and legislators’ decision to fully fund Medicaid expansion. Though the Legislature failed to legislatively halt the governor’s proposed transition to privatized managed care (something that would make the state’s Medicaid administration unnecessarily complicated), the June 1 Supreme Court ruling effectively stopped the Governor’s managed care plan. With Medicaid expansion finally funded, the state now has a number of common sense options to maximize federal Medicaid spending and further ensure access to high-quality, affordable health care for all. [Emma Morris / OK Policy]
• Working families got a little of the help they needed this session: Families are the backbone of our society and economy, but too many Oklahoma families cannot keep up. Many Oklahoma jobs pay less than a quarter of what it takes to support a family. Too many workers don’t have access to paid sick leave, paid family and medical leave, health insurance, or retirement accounts. State legislators regularly hail the importance of Oklahoma families, but their words don’t match their actions. Oklahoma families continued to be underserved by their legislature this session. While the basic structural problems of low-income work, including low pay and lack of paid leave, were left unaddressed this session, many working families will benefit from a long-overdue restoration of the state Earned Income Tax Credit. [Paul Shinn / OK Policy]
• (Capitol Update) What comes next after Supreme Court strikes down managed care plan?: The Oklahoma Supreme Court ruled last week that the actions of the Oklahoma Health Care Authority (OHCA) implementing a capitated managed care plan — at the direction of Gov. Stitt — violated state law and was therefore void. The Court said OHCA acted without legislative authorization and without first adopting necessary administrative rules for the bidding process. [Steve Lewis / Capitol Update]
• Policy Matters: Expansion enrollment numbers encouraging: With the state’s high uninsured rate and generally abysmal health outcomes, Oklahoma elected officials and policymakers have many health care issues facing them during the coming year. However, concerns about program costs due to Medicaid expansion’s high demand should not be among them. [Ahniwake Rose / Journal Record]

Upcoming Opportunities

We’re Hiring: Applications close 5 p.m. today for Criminal Justice Policy Analyst:  OK Policy is now hiring for a Criminal Justice Policy Analyst, with the application period closing at 5 p.m., Monday, June 14. Learn more and apply online.

Weekly What’s That

Supplemental Hospital Offset Payment Program (SHOPP)

The Supplemental Hospital Offset Payment Program (SHOPP) fee is a fee paid by certain hospitals in Oklahoma. The funds are then pooled, matched with federal dollars, and redistributed first to critical access hospitals and then to other hospitals in the state to support their operations. 

Some hospitals are exempt from paying the fee, including hospitals operated by state, Tribal, or federal governments, hospitals that mainly provide certain services like obstetric care or cancer treatment, and long term acute care, children’s, and critical access hospitals. For hospitals that are subject to the fee, it is calculated as a percentage of the hospital’s net patient revenue. Notably, hospitals are prohibited from charging patients any part of the fee.  

Oklahoma statute stipulates that the fee cannot be more than four percent of each hospital’s revenue. The fee is currently set at 2.5 percent. During the 2021 Legislative session, lawmakers passed Senate Bill 1045 that mandated a phased increase in the SHOPP fee. The fee will gradually increase to four percent in calendar year 2024, and will remain at that level in subsequent years. Though not expressly outlined in the bill, legislators have stated that the increased funds will be used to fund Medicaid expansion in future years.

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

Quote of the Week

“(W)e obviously need you, we need those voices, we need people at the table where those decisions are being made … you face hardships that other people wouldn’t face. But the only way that we combat that is by getting more women elected and by making the legislature look more like the population as a whole.”

-House Minority Leader Emily Virgin, D-Norman, about her message to encourage women to run for office [Norman Transcript]

Editorial of the Week

Editorial: Oklahoma voters pull state kicking and screaming into Medicaid expansion

Oklahoma’s move to expanded Medicaid begins July 1. It’s taken too long to get to this point, but it deserves celebrating now that we’re so nearly there. In the first few days of enrollment, nearly 100,000 Oklahomans applied and were approved for the entitlement program that is largely funded by the federal Affordable Care Act.

That will mean a healthier state in the future. Oklahomans who have not had access to primary care physicians will now be able to get medical assistance in dealing with chronic health problems, including obesity, tobacco use and lack of exercise. That means treatable chronic problems will be less likely to become very expensive acute ones, and will be addressed in doctor’s offices instead of emergency rooms.

It will also have a healthy economic impact on the state. More than $1 billion a year in federal funding should flow to the state, helping strengthen the state’s tenuous rural health care system. The state also ends up with a stronger workforce.

Medicaid expansion makes Oklahoma healthier and wealthier.

Some 200,000 U.S. citizens living in Oklahoma are financially eligible for Medicaid under the constitutional mandate approved by state voters last year. Working-age Oklahomans who earn up to 138% of the federal poverty level are eligible, That’s $17,796 for an individual or $36,588 for a family of four.

It took too long for the state to open the door to expanded Medicaid. The state’s elected leadership refused federal funding for the program under the false premise that the state couldn’t depend on Congress to fund the program. We long suspected that the real issue wasn’t about money but politics, a refusal to participate in Obamacare because of the name pinned to it by its opponents. That’s a self-destructive act of partisanship and defies the good of the people.

It meant that Oklahomans paid for expanded Medicaid in other states but weren’t allowed to receive its benefits. The state ended up with the second highest rate of uninsured adults in the nation, more than 16%.

We’re glad to see eligible Oklahomans are embracing Medicaid expansion, and hope more will do so.

[Tulsa World]

Numbers of the Day

• 51,000+ – Number of Oklahomans who have been approved for health care coverage through Medicaid expansion in the first four days that applications were open. [The Oklahoman] 
• 47th – Oklahoma’s national rank for broadband connectivity. [Federal Reserve Bank of Kansas City]  
• 5.5 million – The number of children lifted above the poverty line in 2018 by the Child Tax Credit and Earned Income Tax Credit. [CBPP]
• $1.35 billion – Medicaid expansion is estimated to add $1.35 billion to the state economy in federal dollars in its first year. [Source: Oklahoma Hospital Association & National Center for Rural Health Works]
• $1.5 to $2 – Each dollar refunded through the Earned Income Tax Credit (EITC) to families generates between $1.50 to $2.00 for the local economy from purchases that support local businesses and create tax revenue. Legislators next session have the opportunity to continue building on the success of the Oklahoma EITC to help families and local economies in the state. [Source: National Conference of State Legislatures]

See previous Numbers of the Day and sources here.

What We’re Reading

• Medicaid Expansion in Oklahoma: Creating jobs, helping the state budget, and protecting families [Families USA]
• Disconnected: Seven Lessons on Fixing the Digital Divide [Federal Reserve Bank of Kansas City] 
• Congress Should Adopt American Families Plan’s Permanent Expansions of Child Tax Credit and EITC, Make Additional Provisions Permanent [Center on Budget and Policy Priorities]
• Economic Impact of State Question 802 [Oklahoma Hospital Association & National Center for Rural Health Works]
• Strengthening Paid Leave Policies Could Yield Positive Work and Health Outcomes [Urban Institute]