MM Curator summary
OK Governor and legislators remain at odds over implementing managed care; The Senate passed an alternative plan that has the state running an alternative model (vs managed care companies).
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
OKLAHOMA CITY – Rep. Marcus McEntire, R-Duncan, on Tuesday won passage of a measure that would require the Oklahoma Health Care Authority (OHCA) to implement internal managed care for Oklahoma’s Medicaid program instead of outsourcing it to out-of-state, private corporations.
Senate Bill 131 would replace the governor’s managed care plan.
“I’m for better health and better care at a better price,” McEntire said. “Government funded health care is not government funded. It is funded by our tax dollars, and we are responsible for how we spend those dollars. My conscience demanded I do something that will lead to better health outcomes for Oklahomans and that will better protect the hard-earned money our taxpayers.”
McEntire said Oklahoma hospitals and health care providers have expressed concern that under an outside system, reimbursements for care will be slower, they will be shut out of the decision-making process or be squeezed out of the market altogether by lower payments. For patients, there will be an insurance company standing between them and their physicians, he said.
The governor on Wednesday criticized the House’s passage of the bill.
McEntire said he was disappointed by the governor’s response.
“This is the same bill he endorsed only last year in Washington under the Trump Administration. Now he’s trying to say that leaving healthcare management up to our state is some kind of socialist plot. This measure protects our state from federal overreach. The governor is playing politics with Oklahoman’s healthcare and taxpayer dollars.”
Background:
Last June, Oklahoma voters passed a state question that expanded Medicaid in the state to more low-income adults beginning this July 1. Anticipating this, the state Legislature last session passed a measure known as SoonerCare 2.0 that would have required the Oklahoma Health Care Authority (OHCA) to oversee the expansion. State budget leaders estimated this would cost about $164 million this year.
The governor, however, vetoed that bill and instead directed the Health Care Authority Board to adopt a privatized managed care plan, contracting with four major private health insurers. If nothing is done legislatively, that plan will take effect this fall and cost the state about $2 billion for the contracts being awarded without legislative input or oversight of the expense.
McEntire said he realizes the OHCA may need to contract with some private entities to provide some services and technology required under the state Medicaid expansion plan. But paying billions to private, out-of-state companies when this state agency has done an excellent job in managing this service for the state’s hospitals and health care providers is something he did not want to see happen.
McEntire said the true goal is to see Oklahoma’s overall health ranking improve, but getting people to make better lifestyle choices to improve their overall health is quite different from managing care.
Senate Bill 131 passed with a vote of 73-17. The bill was amended in the House, so it now returns to the Senate for final consideration. Sen. Jessica Garvin, R-Duncan, is the Senate author of the bill.