A bill to expand Medicaid eligibility in Oklahoma so that the state could tap into an infusion of federal funding available under the Affordable Care Act appears to be dead, the state’s Senate leader said on Monday.
With just one week remaining before lawmakers are set to adjourn, Senate President Pro Tem Brian Bingman said there isn’t enough support in the Republican-controlled Senate to approve the plan. A proposed $1.50-per-pack tax increase on cigarettes to help pay for the state’s share was defeated in the Oklahoma House last week, and Bingman said that proposal is also likely dead for the year.
“I think part of the (plan) is the expansion of Obamacare, and I think the Senate has been pretty clear for the last six years that we don’t want to expand that portion … because Oklahoma can’t afford it,” said Bingman, R-Sapulpa.
The plan called for expanding Medicaid eligibility to about 170,000 uninsured low-income Oklahomans and shifting about an equal number of currently Medicaid-eligible pregnant women and children onto the private market. Because of Republicans’ bitter resistance to the federal health care law, the plan was dubbed a “rebalancing” instead of an expansion since the overall number of people on Medicaid was projected to stay the same.
If the plan had received federal approval, the federal government would have covered 95 percent of the state’s Medicaid costs. That figure would have decreased to 90 percent of the share in 2020.
Without more funding, the state’s Medicaid agency has said it would have to impose 25-percent cuts to the reimbursement rates paid to Medicaid providers, a slash so deep that many hospitals and nursing homes have said they would be forced to close their doors.
The Oklahoma Health Care Authority, which oversees the state’s Medicaid program, SoonerCare, was expected to vote Monday to cut provider reimbursement rates by 25 percent, but the agency’s CEO, Nico Gomez, asked to table that item while budget negotiations continue between the House, Senate and governor’s office.
“We scheduled the meeting believing we would have some idea of our budget,” Gomez said in a statement. “That is simply not the case and, as such, my recommendation will be to table the cuts until we have an appropriation.”
Even without passage of the cigarette tax, which was projected to generate about $180 million annually, Bingman and House Speaker Jeff Hickman both have said increasing funding for the agency is a top priority so that rural hospitals and nursing homes are protected.
“We’re trying to prop up what we can there to keep the provider rate cuts to a minimum,” Bingman said. “We keep hearing the 25-percent cuts, but I don’t think you’re going to see anything near a 25-percent rate cut on the provider cuts.”