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Point of View: SoonerCare 2.0's hospital fees hurt mental health

Mike Brose
Mike Brose

Oklahomans want federal health care dollars to support the health and wellness of Oklahomans, but not at the expense of rural hospitals and mental health treatment. That’s exactly what a new proposal in the Legislature would do.

Legislators are expected to vote in the coming days on increasing a hospital fee to fund SoonerCare 2.0, which would partially expand Medicaid but draw down fewer federal dollars and put a larger burden on hospitals. This hurts mental health.

SoonerCare 2.0 proposes nearly doubling the Supplemental Hospital Offset Payment Program (SHOPP) fee. SHOPP helps hospitals cover the cost of treating Medicaid patients and keeps them in business. Increasing SHOPP will disrupt a complicated funding mechanism and create a new set of winners and losers among our state’s hospitals. It’s also of particular concern for mental health because these hospitals are often a front-line resource for Oklahomans with mental illness.

Seven Oklahoma psychiatric hospitals are part of the SHOPP program; this legislation could directly hurt them and their ability to offer adequate care. All general hospitals in the state serve individuals with mental illness and many have dedicated psychiatric units that would be disrupted. SHOPP changes would especially impact rural hospitals, which would deeply affect mental health treatment in our rural communities. When the larger hospital system is disrupted, the effect ripples throughout the mental health treatment system and is felt by providers and individuals needing treatment.

In addition, SoonerCare 2.0 calls for reallocating a portion of the Department of Mental Health and Substance Abuse Services’ budget, which is currently used to treat uninsured individuals. The thought is some individuals would now qualify for Medicaid and, thus, dollars saved could be reallocated elsewhere. The reality is the reallocation of these funds is based on theoretical projections and, ultimately, would prevent us from serving more people impacted by mental illness. Oklahoma already ranks among the lowest states per-capita in mental health spending but high in mental illness. We need more money for treatment and to improve overall outcomes.

Equally troubling, SoonerCare 2.0 is a block grant model that would restrict the number of federal dollars that would come back to Oklahoma.

This and other details of the plan are highly experimental and unproven and will be tied up in federal court for years. Work requirements, which are a key part of the SoonerCare 2.0 plan, have already been struck down in federal court several times.

The question before legislators now, though, is nearly doubling the SHOPP fee for hospitals. Health care at the expense of hospitals and mental health treatment is no solution. Legislators should vote no on changes to SHOPP, and Gov. Kevin Stitt should let the voters decide on State Question 802, which would expand Medicaid and bring nearly $1 billion in federal funding to Oklahoma each year to support expanded service options. Make your voice heard to ensure Oklahomans have the best possible health care options — SoonerCare 2.0 is not it.

Brose is CEO of the statewide nonprofit agency Mental Health Association Oklahoma.