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Study: Thousands in Oklahoma could lose Medicaid coverage

Oklahomans gather at the Oklahoma Capitol during a Medicaid Matters rally in 2016. [The Oklahoman archives]
Oklahomans gather at the Oklahoma Capitol during a Medicaid Matters rally in 2016. [The Oklahoman archives]

Oklahoma City — Thousands of Oklahomans could lose Medicaid coverage if the state is allowed to implement work requirements for the public health insurance program, according to a study from the Georgetown University Center for Children and Families.

The study found anywhere from 4,000 to 13,000 adults could lose coverage. Whether losses are on the high or low end, and whether Oklahoma's work requirement is approved at all, will depend on decisions by the federal Centers for Medicare and Medicaid Services.

Last year, then-Gov. Mary Fallin directed the Oklahoma Health Care Authority to ask CMS for permission to require adults to work or volunteer 20 hours a week if they receive health coverage through Medicaid, which is funded by states and the federal government.

The request seeks to exempt recipients who are older than 50, who have a disability, who are caring for a child younger than 6 or who are American Indian. It isn't clear how disability will be defined, however, and CMS has indicated it will object to exemptions for tribes since President Donald Trump took office.

Jo Stainsby, spokeswoman for the Oklahoma Health Care Authority, said the agency couldn't comment on Georgetown's estimates because the exemptions haven't been finalized.

In Oklahoma, adult Medicaid enrollment is limited to people with serious disabilities, seniors who need long-term care and parents who have incomes below 45 percent of the poverty line, or $9,351 for a family of three. If CMS gives its approval, Oklahoma would be the first state that hasn't expanded Medicaid to set up a work requirement.

If the work requirement is approved, recipients would have to careful what jobs they took and how many hours they worked. Working 20 hours a week at a $10 per hour job would yield a monthly income of about $800 — too high to qualify for Medicaid in Oklahoma. Even at a minimum wage job, consistently working 27 hours a week would put their income over the threshold.

Jonathan Small, president of the conservative Oklahoma Council of Public Affairs, questioned some of the report's assumptions, including that children would lose Medicaid coverage, and that adults who worked extra hours wouldn't get private health insurance.

“The report makes some assertions that people wouldn't find coverage,” he said. “They're just assertions.”

While the requirement doesn't target children's insurance, some likely will lose coverage because their parents may not know they're still eligible, said Carly Putnam, policy director at the nonpartisan Oklahoma Policy Institute.

Another concern is that the health care authority had trouble reaching recipients for a phone survey about barriers to employment, raising questions about whether it can get out the word about new reporting requirements to people who need to comply, she said.

“If they couldn't reach half of the sample of a hundred, what's going to happen when it's done on a much broader scale?” she said.

Stainsby said reaching 50 percent of people in a phone survey isn't a bad result, and that the health care authority will use multiple channels to reach recipients. She said the agency would develop an outreach plan once it knew the specifics of what the federal government would approve for the work requirements.

People who want to comment on the proposed work requirements can do so at Comments are due by 11 p.m. Friday.

Meg Wingerter

Meg Wingerter has covered health at The Oklahoman since July 2017. Previously, she lived in Topeka, Kansas, and worked at Kansas News Service and The Topeka Capital-Journal, where she earned awards for business coverage. She graduated from... Read more ›