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State officials grapple with future of insurance premium support program for Oklahoma’s working poor

Governor Mary Fallin
Governor Mary Fallin

By Patrick B. McGuigan
Associate Editor

Oklahoma leaders remain cautiously optimistic about preserving a popular insurance premium support program, designed and implemented in 2004 with bipartisan support, which benefits the working poor.

On May 9, Leavitt Partners, a consultant to Oklahoma’s Health Care Authority (HCA), encouraged state officials to extend Insure Oklahoma, despite the Obama Administration’s decision to spike the program’s Medicaid revenue stream.

Cindy Mann, director of the Centers for Medicare & Medicaid Services at the U.S. Department of Human Services, based in Baltimore, Maryland, delivered the death sentence to the Oklahoma program — created in 2004 by a popular vote, and fashioned by a bipartisan consensus – in a May 7 letter.

Referencing the Affordable Care Act (ACA), Mann wrote, “The new law will mean that an extension of the Insure Oklahoma program without any changes is not possible.”

In her letter, Mann contended the federal government is “committed to working with you on approaches that work for Oklahoma.” However, she continued, the SoonerCare section 1115 demonstration (No [email protected]/6) includes enrollment caps which “will not be approved.”

Mann suggested the program, which has provided access to the insurance market for thousands of low-income working Oklahomans could be revised to include “products available in the individual and small business insurance market.” She wrote the federal agency “would welcome working with you … consistent with our guidance.”

Despite the agency’s refusal, Mann wrote, “should the state decide to phase out the Insure Oklahoma program at the end of 2013, a phase out plan as provided for in paragraph 9 of your approved Special Terms and Conditions is due … by July 1, 2013.”

In a blunt reply to the letter from Mann, Oklahoma Gov. Mary Fallin said on May 8:
“This is the latest bad news in the ongoing train wreck that is the Affordable Care Act. It is outrageous that President Obama is actively dismantling the successful health care programs established by states in order to force citizens onto Obamacare health insurance plans.

“The president promised the American people, ‘if you like you’re health insurance, you can keep it.’ He has not kept his word. Thirty thousand Oklahomans participating in Insure Oklahoma – and many more Americans across the country – are being forced off their health insurance plans.

“The president also promised the nation’s governors his administration would grant states the flexibility to pursue state-based solutions rather than one-size-fits-all policies. Again, that has proven to be untrue, as Oklahoma and other states are now finding their programs and waivers under assault by the Obama Administration.”

In a presentation to HCA last Thursday, Leavitt’s Michael Deily recommended several possible steps to increase health insurance access for low income Oklahomans. In some scenarios, the state could revise Insure Oklahoma to meet requirements of the U.S. Department of Health and Human Services.

After Leavitt’s “power point” presentation, Nico Gomez, chief executive officer at HCA, said he was interested in the recommendation to preserve Insure Oklahoma: “We have a state innovative program called Insure Oklahoma that we’ve had since 2004 and we’d like to figure out a way to keep that operation because it’s doing exactly what the Affordable Care Act is attempting to do but in a more responsible way.”

However, other analysts caution against any form of “ObamaCare” implementation. Some have suggested the state decouple Insure Oklahoma from federal Medicaid funding, instead using exclusively resources from the Tobacco Settlement fund to preserve the acclaimed program that provides insurance premium assistance to many of the Sooner State’s the working poor.

In response to question from The City Sentinel, Gov. Fallin’s spokesman explained a comment on low income health care she made in a speech to the spring task force of the American Legislative Exchange Council (ALEC).

Alex Weintz, communications director for the chief executive, said she would be reviewing the Leavitt Partners recommendations, but “She has not proposed using Medicaid dollars to purchase private insurance, although she is aware that others have.”

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