Medicaid expansion advocates accuse Stitt of political ploy

Jun. 26--Supporters of State Question 802 accused Gov. Kevin Stitt of playing politics on Thursday when he and other state officials announced the results of an audit of the Oklahoma Health Care Authority -- the state agency that oversees Oklahoma's Medicaid program -- five days before an election on Medicaid expansion.

Stitt, State Auditor Cindy Byrd and Health Care Authority CEO Kevin Corbett said a performance audit of the agency indicates state health officials need to be more vigilant and use more accessible data to verify the income of those seeking Medicaid benefits.

Medicaid is a state-federal partnership that provides health insurance coverage for low-income children, parents and disabled adults. State Question 802, which seeks to expand Medicaid in Oklahoma, would allow additional low-income adults between the ages of 18 and 65 to qualify for Medicaid benefits.

Stitt, who opposes SQ 802, has spent some time in the days leading up to Tuesday's election actively campaigning against the measure.

In a press conference Thursday, he reiterated his opposition to the question, noting his concern that the federal government could someday reduce the match rate, in which the state pays 10% of the expansion costs.

"We are putting something in our constitution that handcuffs us for any future change," he said. "So, as the feds decide to change this program, it's going to obligate Oklahoma taxpayers to continue to fund it."

In an email Stitt's campaign sent out earlier in the day, he noted that among the reasons he opposes SQ 802 is because it could cost "Oklahoma taxpayers up to $374 million annually," seemingly inflating cost estimates for the state's share of the expansion.

Estimates from the Health Care Authority suggest the state's share would be about $164 million annually, a figure that could rise due to increased unemployment because of the COVID-19 pandemic and because of the "woodwork effect," in which more people who currently are eligible for Medicaid seek benefits because the expansion puts it on their radar.

The Oklahoma Policy Institute, which supports State Question 802, said the audit's release mere days before Tuesday's election was calculated.

"The data presented during the briefing doesn't immediately appear to align with findings from previous state and federal audits, which occur frequently and rigorously," the think tank said in a statement. "It was unclear what the purpose of today's press conference was other than misdirection for Oklahoma voters as they head to the polls to decide SQ 802."

Stitt requested the audit in March 2019. The Health Care Authority is audited annually by the state and periodically by the federal government.

Roughly 25% of the state's population is enrolled in Medicaid. The state appropriates more money to Medicaid than any other program.

The audit found the authority "does not have adequate internal controls in place to ensure compliance with federal laws and regulations that require only eligible participants receive Medicaid and CHIP benefits."

"We want to know that no one ineligible is receiving benefits," Byrd said. "We had a large population where the income was not verified. We're never going to get that number to zero. There's always going to be a risk there, we just need to get it to a manageable number."

Byrd projected that nearly $30 million in Medicaid Children's Health Insurance Program claims were paid out to ineligible residents.

Stitt suggested the state should take longer to verify the eligibility of beneficiaries. Federal regulations allow up to 45 days to verify an applicant's information, which is now typically done within a 24-hour period.

The state uses electronic wage data from the Employment Security Commission to verify income, but that data also could be checked more frequently than it currently is, state officials suggested.

Corbett, head of the Health Care Authority, suggested the state check other income sources to verify income eligibility.

The Oklahoma Policy Institute suggested Stitt lacks vision for how to reform health care in Oklahoma.

"The lack of clarity about a plan to address the findings -- combined with the governor's ongoing silence about the future of his SoonerCare 2.0 proposal -- signal that lawmakers and elected officials continue to lack a deliverable vision for health care in Oklahoma," the group said in a statement. "This further underscores that SQ 802 is the best path forward to make sure Oklahomans get the health care they urgently need."

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