SMC leader supports Medicaid expansion

Jun. 19--A coalition of Oklahoma healthcare professionals and organizations announced last week that it was launching an initiative to let voters decide whether to bring Medicaid expansion to Oklahoma. The group, which is operating under the name Oklahomans Decide Healthcare, says it wants voters to have a direct say on accepting federal money to expand eligibility for Medicaid to an estimated 200,000 Oklahomans, something the Oklahoma legislature has not gotten done.

On Tuesday, the Oklahoma Supreme Court issued a decision clearing the way for that initiative.

The coalition says expanding the eligibility criteria for Medicaid would provide greater access to healthcare for every Oklahoman and bring more than $1 billion to Oklahoma from the federal government.

Supporters of Medicaid expansion have said making more Oklahomans income-eligible would boost the state's economy. Many of Oklahoma's uninsured adults have jobs that don't come with health insurance -- a challenge faced by a significant number of farmers, ranchers and small business employees. They earn too much to qualify for existing Medicaid and too little to be able to afford care on the health insurance exchange.

Stillwater Medical President and CEO Denise Webber is part of the coalition promoting Medicaid expansion. She says she has seen how Oklahoma's decision to reject federal funds has hurt lower-income residents and healthcare facilities, especially in rural areas.

Stillwater Medical operates clinics in many of the smaller communities located near it's main facility, operates Perry Memorial Hospital and has a management agreement with Blackwell Regional Hospital.

Stillwater Medical Center sees patients with a mix of Medicare, Medicaid and private insurance, but Webber said patients in the rural areas Stillwater Medical serves primarily rely on Medicare, Medicaid or self-pay.

She says the lack of funding has been devastating for many of the rural hospitals in the state, which have average operating margin of 1%, which doesn't provide enough to reinvest in facilities or give raises to staff.

Others haven't survived, leaving their communities without access to health care.

"Since 2016, eight hospitals have declared bankruptcy and six have closed their doors -- all in rural Oklahoma." Patti Davis, president of the Oklahoma Hospital Association, said.

SMC took over operation of Perry Memorial Hospital in April 2018, after representatives from the community approached the hospital about a partnership in a last-ditch effort to keep Perry Memorial open.

At the time, Perry Mayor Gordon Johnson said the hospital had been losing money for years and would have shut down the next month.

"We have a 26-bed hospital; Our census was six," Johnson said. "... We just could no longer provide that amount of care. We were losing hundreds of thousands of dollars every year because we were trying to maintain a 26-bed hospital, full service hospital, in a rural community that's 70 percent, probably, are Medicare patients."

Hospitals in Fairfax, Drumright and Stigler joined other small hospitals owned by EmpowerHMS and its affiliates in filing bankruptcy in March. Staff at several of the Oklahoma hospitals worked for weeks without pay.

Expanding Medicaid would help people who find themselves in the gap, making too much to qualify for assistance but not enough to afford insurance, Webber said. People go without insurance or are forced to buy policies that have deductibles up to $10,000 effectively leaving them uninsured for anything other than catastrophic illnesses.

"Failing to take the opportunity to cover the uninsured by accepting available federal funds has hurt many families in northern Oklahoma and continues to increase health care costs. This urgently needs to change," Webber said. "It doesn't make sense to send billions of our tax dollars to Washington, D.C. when we can keep the money here and provide needed care for our community members."

Under expansion, Medicaid would be available to those making less than 133% of the federal poverty level, which is about $17,000 a year for an individual or $28,000 for a family of three.

Webber said the Medicaid reimbursement rate is low, but at least it's something and it would help the people and medical facilities in rural areas.

Dr. Jason Lepak, a Tulsa physician who is a member of Oklahomans Decide Healthcare, says by the time many patients without insurance seek help, their conditions have become incredibly costly to treat -- costs that are often passed along to taxpayers and those who already have insurance. Medicaid expansion, he says, would provide a better way forward.

"This will help ensure that there's hundreds of thousands of Oklahomans who have access to life-saving emergency care, it will keep rural hospitals open, and it will create thousands of jobs," he said.

Thirty-six states have already accepted federal funding to expand Medicaid. Last year, voters in Utah, Nebraska, and Idaho all approved Medicaid expansion.

Twitter: @mcharlesNP

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