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Advancing Medicaid reform


Rep. Doug Cox August 20th, 2013

Not surprising to me, recommendations recently made by the Leavitt Partners (a consulting group hired to study the state’s Medicaid system and alternatives for addressing the Affordable Care Act) closely mirrored those made by Sen. Brian Crain, R-Tulsa, and me. Contained in Senate Bill 640, which did not get a hearing last session, these recommendations form a road map for Oklahoma’s future health care for low-income citizens.

The consultants recommended accepting federal Medicaid-expansion funding but using it to underwrite private insurance purchases for poor Oklahomans. SB 640 would have given these citizens a choice of private insurance or the present SoonerCare insurance plan.

The Leavitt Partners wanted to push eligible clients to use the ACA’s health-insurance exchange and Indian Health Services. SB 640 did the same by essentially restricting Medicaid to those making less than 138 percent of the federal poverty level (those over that level will fall into the federal exchange, which takes effect Jan. 1).

The study recommended negotiating with the feds to extend the Insure Oklahoma program. SB 640 did the same.

In addition to motivating healthy behaviors, SB 640 would go even further in implementing quality assurance programs by hospitals and physicians, as well as cost-containment measures in pharmacy, medical equipment and surgical procedures.

Perhaps most importantly, the Leavitt consultants illustrated how accepting federal dollars to expand Insure Oklahoma would have a net economic impact on our state.

The study vindicates the ideas put forth in SB 640 and would seem to justify a conversation with Gov. Mary Fallin and her commissioner of health, Terry Cline, on the measure.

The Leavitt report gives justification to fiscal conservatives such as myself and my Republican colleagues that we should look at accepting a return of our federal tax dollars to Oklahoma for the purpose of not only continuing but expanding Insure Oklahoma.

SB 640 is not simple Medicaid expansion. It is Medicaid reform. It requires that participants either be working or looking for a job (unless they are disabled, caring for an elderly relative or are a single parent caring for a child under 12). It increases personal responsibility with limited co-pays for care and medication.

For critics who say SB 640 is simply “Obamacare,” I point out that there are no fines or tax penalties for those who do not participate. The program is voluntary. That makes it far different from Obamcare.

It is my hope that Gov. Fallin will add consideration of SB 640 to the upcoming special session. If we cannot sit down and have a civil discussion between the executive and legislative branches of government, between Democrats and Republicans, to work out an acceptable compromise on something as important as health care, then both this country and state are in trouble.


Cox, an emergency room physician, is a Republican from Grove representing District 5 in the Oklahoma House.

 
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