Senate committee advances Medicaid expansion bill

Feb. 18--A bill that would use Medicaid expansion funds to increase Oklahoma's private-insurance subsidy program for low-income residents was approved on Monday by a Senate committee.

"This bill will expand Insure Oklahoma to the population Medicaid expansion would have covered," said Sen. Greg McCortney, the author of Senate Bill 605. "Instead of having the (state) Health Care Authority become a huge health care provider, what we are proposing to do is purchase health insurance plans for these people through private insurers."

Insure Oklahoma is a program that helps fund coverage for low-income working adults or Oklahomans who can't access health insurance through their employer.

McCortney, R-Ada, said the plan would access nearly $1.2 billion from the federal government, with Oklahoma paying around $141 million.

The Medicaid funds would be used for health insurance premium assistance through a commercial health insurer.

Individuals making less than 138 percent of the federal poverty level who also meet work requirements would be eligible.

"It's not a Medicaid expansion," said Carly Putnam, a health care policy analyst at the Oklahoma Policy Institute. "It's using the federal dollars intended for Medicaid expansion for a private, Oklahoma plan."

Putnam said the bill is similar to Medicaid expansion programs in Arkansas and Indiana, taking advantage of federal flexibility to impose work requirements and utilize private insurers.

"The details really aren't there yet," Putnam said. "But it's the beginning of a really important discussion."

Oklahoma is one of 14 states that has not accepted Medicaid expansion. Republican lawmakers in Oklahoma have consistently opposed the program, which was part of former President Barack Obama's signature health care reform act.

But as Oklahoma continues to have some of the nation's highest uninsured rates and rural hospitals struggle to remain open, there appears to be a willingness among more state lawmakers to consider accepting the expansion funds.

SB 605 would require a waiver from the federal government. McCorntey said he expected the waiver would be granted.

"We have an administration in Washington D.C. that has indicated they are willing to sign off on something like this," McCortney said.

Gov. Kevin Stitt has said he might be open to Medicaid expansion under certain circumstances. Stitt said he would not approve any Medicaid expansion bill until he was given the authority to hire the director of the state Health Care Authority.

Stitt has also expressed concern that the federal government could take away funding for the Medicaid expansion program in the future, something that has never happened.

At Monday's committee hearing, McCortney said his bill would include language requiring the Legislature to decide on the program's future if the federal government ever ended the Medicaid expansion program.

Senate President Pro Tem Greg Treat, who voted in favor of the bill in committee, said he expected the bill to evolve as it works its way through the Senate.

"That's still a definite work in progress," said Treat, R-Oklahoma City. "My caucus has opinions that run the gamut on Medicaid. But we are trying to find way to make sure we increase access, especially in rural Oklahoma, without over obligating the state on the state share. We are taking it step by step."

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