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Good news and bad news on Managed Care: A Commentary

Patrick B. McGuigan, Special to The Southwest Ledger

Hopes for a fully operational Managed Care system for implementation of Medicaid Expansion in Oklahoma probably ended on Wednesday (May 19).

There are enough nuances in the legislation that it is difficult to discern fully what it really means – assuming the House approves the Senate changes (as seems likely) and the measure goes to Gov. Kevin Stitt.

Even then, if Stitt vetoes it, perhaps some or even many Republicans will vote to sustain his veto.

The bad news about Senate Bill 131 is that despite apparent improvements made in a Senate Conference Report, the measure passed 39-8.

The good news is that many provisions within this still-lousy bill have drawn the scrutiny of well-informed opponents.

The bad news is that in its present form, it essentially locks in for several years the guaranteed profits of the largest “nonprofit” entities in Oklahoma health care. Those are the status quo players who characterized Managed Care (a system operating in 40 states) a “Health Care Hold-Up.”

The good news is that some Medicaid recipients and some important parts of the new system will still evolve toward a Managed Care system, as health care reformers had hoped.

The bad news is that some Medicaid recipients will, for now, be outside any sort of Managed Care. Those folks will remain trapped within parts of the system which hide true costs (a problem that might have ameliorated by a reform that got spiked a few weeks ago).

Although the good news is that the governor might still veto, the bad news is that he would likely be overridden — although that is not quite certain.

The good news is that the work of those who criticized S.B. 131 after it became a method to erode Gov. Stitt’s executive authority did im- pact the debate. Their efforts caused some meaningful changes to the original bill.

The bad news is that it is still lousy, piece-of-crap legislation.

The further bad news is that SB 131 falls into that immortal category of legislation on which both sides (primarily, to be sure, those in the legislative majority) can declare victory, while not really advancing the interests of beneficiaries of health care.

HOW THE SENATORS VOTED ON MAY 19

Supporting Senate Bill 131 on Wednesday were Sens. Mark Allen, R-Spiro; Micheal Bergstrom, R-Adair; Mary Boren, D-Norman; Michael Brooks, D-Oklahoma City; David Bullard, R-Durant; George Burns, R-Pollard; Bill Coleman, R-Ponca City; Jo Anna Dossett, D-Tulsa; J.J. Dossett, D-Owasso; Tom Dugger, R-Stillwater; Kay Floyd, D-Oklahoma City; Jessica Garvin, R-Duncan; Chuck Hall, R-Perry; Warren Hamilton, R-McCurtain; John Haste, R-Broken Arrow; Carri Hicks, D-Oklahoma City; Brent Howard, R-Altus; Darcy Jech, R-Kingfisher; Chris Kidd, R-Waurika; Julia Kirt, D-Oklahoma City; James Leewright, R-Bristow; Kevin Matthews, D-Tulsa; Greg McCortney, R-Ada; and Jake Merrick, R-Yukon.

Also voting yes were: Joe Newhouse, R-Tulsa; Roland Pederson, R-Burlington; Dewayne Pemberton, R-Muskogee; Adam Pugh, R-Edmond; Marty Quinn, R-Claremore; Dave Rader, R-Tulsa; Paul Rosino, R-Oklahoma City; Frank Simpson, R-Springer; Rob Standridge, R-Norman; Brenda Stanley, R-Midwest City; Blake Stephens, R-Tahlequah; Zack Taylor, R-Seminole; Greg Treat, R-Oklahoma City; and Darrell Weaver, R-Moore.

Voting against passage were Sens. Nathan Dahm, R-Broken Arrow; Julie Daniels, R-Bartlesville; Kim David, R-Porter; Shane Jett, R-Oklahoma City; John Michael Montgomery, R-Lawton; Lonnie Paxton, R-Tuttle; Cody Rogers, R-Tulsa; and George Young, D-Oklahoma City.

Not voting on Senate Bill 131 was Sen. Casey Murdock, R-Felt.

NOTE: This analysis first appeared in The Southwest Ledger, May 20, 2021 print edition and online:  Southwest Ledger, 7602 US Highway 277, Elgin, OK 73538, (580) 350-1111. It is reposted here with permission. Oklahoma journalist Pat McGuigan is writing a series of reports, analyses and commentaries on Medicaid Expansion and Managed Care.