March 8, 2021

INDAC

Keep Fit & Healthy

Health issues to watch during Oklahoma’s 2021 legislative session

3 min read

Oklahoma lawmakers face the daunting task of funding Medicaid expansion while the executive branch overhauls the program entirely.



  • Catherine Sweeney

Oklahoma lawmakers have their work cut out for them on the health front.

The Legislature will have to fund Medicaid expansion and likely a managed Medicaid program. Several members filed legislation that highlight anxieties in the pandemic, such as bans on employer immunization requirements. And with a conservative majority on the Supreme Court, the state’s Republican supermajority is certain to approve more legislation to limit abortion access.

Paying for Medicaid Expansion

This summer, Oklahomans approved Medicaid expansion, which opened the health coverage program to about 200,000 low-income adults. Medicaid uses state and federal funding. States pitch in a certain amount, which triggers a federal match. That match is elevated for expansion. For each dollar a state invests, the federal government contributes $9. Oklahoma’s share of the Medicaid expansion cost is expected to be about $150 million.

During the 2020 legislative session, which ended before the state question vote in June, Gov. Kevin Stitt considered expanding Medicaid on his own. However, when the pandemic hit, the office raised concerns that increased demand could make the program too costly.

Before the administration abandoned the plan, it worked with the Legislature to fund it. They increased a fee hospitals pay into Medicaid to draw down more federal match. Senate Pro Tempore Greg Treat said it is likely the Legislature will revisit that option.

That could be more complicated now than it was then.

Managed Care and the Legislature

Stitt and his administration have begun implementing managed care. Under that policy, the state will divert about $2 billion in Medicaid spending to four insurance companies, which will coordinate care for about 75 percent of the state’s Medicaid population — between 700,000 and 800,000 people.

The state’s medical industry groups have severely criticized the program, which will be known as SoonerSelect. The Oklahoma Hospital Association has noted that it would change how Medicaid pays hospitals, which will make the fee hospitals pay into Medicaid less predictable.

Managed care has several critics in the Legislature, but it’s unclear whether that branch has any control over the program. That could be tested before the Oklahoma Supreme Court soon. Several medical trade groups, including the Oklahoma State Medical Association and Oklahoma Dental Association, filed a lawsuit before the court challenging the program’s constitutionality. One of the challenges hinges on whether the executive branch can implement SoonerSelect without legislative approval.

More Health-Related Bill We’re Watching

Several members filed legislation that would preempt vaccination requirements, either by the government or by employers. A handful have been referred to committee, which means they cleared their first hurdle before passage.

The Oklahoma Legislature filed 17 bills that pertain to abortion. In its first meeting since the spring, when Legislature shut down because of the pandemic, the Senate Committee on Health and Human services heard bills six on abortion — about a third of the bills that made it to the hearing. Members left the hearing to heckling by unmasked anti-abortion protesters, who said the legislature wasn’t taking enough action to protect human life.


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