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Consultants unveil plan for Oklahoma uninsured

Sean Murphy, Associated Press

OKLAHOMA CITY (AP) -- Oklahoma should use its existing Insure Oklahoma program as a framework to take advantage of increased federal Medicaid funding and expand health insurance coverage to as many as 274,000 low-income uninsured residents, a health consultant told state health officials on Thursday.

Utah-based Leavitt Partners presented its much-anticipated report to the governing board of the Oklahoma Health Care Authority, the state agency that oversees the federal Medicaid program. The firm was hired to help Oklahoma answer the question of how to expand health insurance coverage after Gov. Mary Fallin rejected an opportunity to expand the state's Medicaid program under the federal health care law, the Affordable Care Act.

The Insure Oklahoma program uses Medicaid and Oklahoma tobacco tax money to help about 30,000 people buy private insurance, but the federal government has denied a waiver that allows the program to operate. It is set to expire on Dec. 31.

The federal waiver plan recommended by Leavitt involves streamlining eligibility into the state's Medicaid programs, providing incentives for positive outcomes and incorporating some cost-sharing elements.

"This approach is using the enhanced federal funds, but we believe it is beneficial to Oklahoma because it does it in a way that allows Oklahoma to target and develop programs that meet the specific needs of its population," said Laura Summers, director of state intelligence for Leavitt. "It's tying into those individual accountability pieces. It's tying into those increased cost-sharing pieces. But it's also addressing the very needs of the population."

The Health Care Authority authorized a $500,000 contract with Leavitt to develop the report, but the company came in under budget and the final cost was about $248,000.

Besides requiring federal approval, implementing the plan would require numerous statutory and rule making changes, and Leavitt recommended immediately developing a steering committee that includes state health officials, legislators and representatives from the governor's office.

Oklahoma's Republican-controlled Legislature has bitterly opposed any attempt to implement components of the Affordable Care Act. Conservatives and tea party group praised Fallin's decision last year to reject Medicaid expansion and not establish a state-based exchange for purchasing health insurance.

But more than 636,000 Oklahomans, or 17 percent of the state's population, currently have no health insurance and drive up the cost of health care and insurance premiums because they often seek medical attention in hospital emergency rooms, where health care is more costly.

Fallin spokesman Alex Weintz said Thursday the governor is still working to preserve the Insure Oklahoma by petitioning the Centers for Medicare and Medicaid Services for a waiver.

"Governor Fallin will review the Leavitt recommendations with her partners in the state Legislature to explore where consensus can be found and how the state can best move forward," Weintz said. "Her goal continues to be improving access to high quality, affordable care for all Oklahomans. However, like most Oklahomans, she does not believe that the Medicaid expansion outlined in Obamacare is an acceptable way of achieving these results."

If Oklahoma were to adopt the recommendations outlined in the Leavitt report, it could be able to expand coverage over the next 10 years to between 187,000 and 275,000 Oklahomans who are currently uninsured, the report states. The company projected that while the direct cost to the state would be $850 million over the next decade, the savings achieved through greater efficiencies and improved outcomes would result in a net cost of $158 million over that same period.

When calculating the increased revenue that would be generated through billions of dollars in new federal Medicaid dollars flowing into the state, the company projects the state would actually see a positive growth of $464 million.

"You'd have this influx of additional dollars into the state. Hospitals may have to hire additional people, increase laundry services. All of that is going to have a net effect on the state," Summers said. "If you take into account that additional revenue to the state, we actually estimate there will be a savings to the state of $464 million over a 10-year period."


Sean Murphy can be reached at www.twitter.com/apseanmurphy