live: Watch: Unemployment commission to host 3 p.m. press conferencelive: Demonstration on George Floyd death planned for 2 p.m. in Normandeveloping: Curfew limits access to neighborhood around downtown OKC police headquarters

NewsOK: Oklahoma City News, Sports, Weather & Entertainment

Voters ultimately will decide Oklahoma's Medicaid route

Gov. Kevin Stitt’s proposal to use federal block grants to fund Oklahoma’s Medicaid program is the antithesis of what’s being sought in a pending state question that would significantly expand coverage. Voters — at some point — will make the ultimate determination.

Backers of State Question 802, which if approved would expand Medicaid to roughly 200,000 Oklahomans, collected more than 313,000 signatures, the most for any initiative petition in state history. That indicates a public desire for the proposal, which would expand Medicaid to cover adults younger than 65 whose income doesn’t exceed 133% of the federal poverty level.

The Affordable Care Act allows states to add able-bodied adults to Medicaid, with the government covering 90% of the cost and states 10%. Supporters of Oklahoma expansion say the inflow of federal money will improve individual health outcomes and help medical providers, especially rural hospitals.

Stitt and others who oppose full expansion worry about rising costs to the state, as has happened elsewhere — estimates for Oklahoma have ranged from $150 million per year to about $375 million. Opponents also note that better health outcomes and economic growth from full expansion aren't a given.

Stitt joined members of the Trump administration Thursday in announcing his plan, called SoonerCare 2.0, as part of the administration's block grant program that lets states request a set amount of federal funding to spend on Medicaid, instead of the state getting reimbursed by the government based on a funding formula. The goal is to better control costs.

Stitt says SoonerCare 2.0 will do that by, among other things, changing to a system that rewards health outcomes and better performance in care, and moving away from a "fee-for-service" model. The state will look to implement requirements that enrollees eiither work, attend school or a certification program.

The block grants will allow for programs that address needs in rural Oklahoma and expand treatment for opioid addiction, Stitt says.

Legal challenges to the Trump administration’s policy are likely. “It’s very hard to square the Medicaid statute with a true block grant proposal,” Nicholas Bagley, a health law professor at the University of Michigan, told Stitt's plan will elicit criticism as well.

The language of the pending state question is such that if it’s approved, SQ 802 would supercede the Stitt plan. Thus, Stitt, who hasn't said when SQ 802 will be on the ballot, has to hope his plan will be well enough received that voters reject the state question.

“I’m going to be proactive,” the governor said last week, “and I’m going to do something this legislative session to answer the needs of Oklahomans.” Results from the ballot box will be the final arbiter.

The Oklahoman Editorial Board

The Oklahoman Editorial Board consists of Kelly Dyer Fry, Publisher, Editor and Vice President of News; Owen Canfield, Opinion Editor; and Ray Carter, Chief Editorial Writer.. To submit a letter to the editor, go to this page or email... Read more ›