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Medicaid Makeover: Oklahoma House Passes Key Health-Care Reform Measure, House Bill 2842

Posted on: Tuesday, 14 March 2006, 21:00 CST

By Marie Price

A bill to bring about a major revamping of Oklahoma's Medicaid system passed the state House on Monday by 81-17.

Supporters say House Bill 2842, by state Rep. Kris Steele, R-Shawnee, will save more than $100 million while providing program participants health care coverage tailored to their needs.

Opponents said they fear the measure could mean reduced services for Medicaid recipients.

Under the bill, those on Medicaid would choose from a menu of options, depending on their health-care needs.

Participants could choose to opt out of Medicaid and use a state-allocated payment to participate in an employer-sponsored health care plan.

Far too many government programs simply tell people what to do, Steele said. It's time to give Medicaid recipients more control over their health care, as well as more options and more responsibility.

Steele said that under the bill many of the more than 600,000 Oklahomans on Medicaid could be covered by private insurance companies.

HB 2842 would direct the Oklahoma Health Care Authority, the state Medicaid agency, to implement a personal health account program for participants.

It also appropriates $93 million to the authority to increase Medicaid reimbursement rates for hospitals and doctors that provide care for Medicaid patients.

State Rep. Lucky Lamons, D-Tulsa, tried to get House rules suspended for an amendment that would extend reimbursement protection into future years, but his motion failed.

Lamons said Tulsa-area hospitals provide about $100 million a year in uncompensated care.

Health-care policies issued under the reform program would not be subject to numerous mandates upon other health insurance policies, such as requiring them to provide coverage for mammography screening, bone-density testing, diabetes supplies and services, obstetrical/gynecological examinations, child immunizations, prostate cancer screening, colorectal cancer exams and other items.

An amendment by House Democratic Leader Jari Askins, D-Duncan, to remove these exemptions was tabled by Steele.

Steele said there is no reason to mandate such coverage if a particular recipient does not need them.

With Oklahoma's Medicaid program looming on a crisis, we can no longer afford to wait for significant reforms, House Speaker Todd Hiett, R-Kellyville said. Medicaid recipients deserve to have more choices, and they should not be treated like second-class citizens. Our reforms are a comprehensive, forward-thinking solution.

State Rep. Al Lindley, D-Oklahoma City, debated against the bill.

This is a train wreck getting ready to happen, Lindley said.

Lindley questioned how recipients can know what types of coverage they may need in the future under the bill's coverage- selection feature.

State Rep. John Wright, R-Broken Arrow, said the revised program would enhance care and provide better bang for the buck.

State Rep. Bill Nations, D-Norman, said there is no track record to show that changes such as personal health care accounts save money or improve care.

Nations also said he doubts that private insurance carriers can adequately cover low- income people now on Medicaid.

State Rep. Doug Cox, R-Grove, a physician, said that as a patient advocate he would not support the bill if he thought it would not improve care.

It will level the playing field and let Medicaid patients receive the same type of care we receive, he said.

The new Medicaid program, to be phased in over a period of years, includes several recommendations from the House Medicaid Reform Task Force., which identified more than $100 million that could be used more efficiently by reconfiguring the Medicaid program.

Askins said removal of the coverage required of other health insurance programs was not part of the task force's recommendations.

Askins opposed moving from the current fee-for-service Medicaid program.

Nothing is cheaper than free for service, unless you don't provide the service, she said.

Askins also predicted that the massive changes in the bill would result in some people currently on Medicaid being moved into the ranks of the uninsured.

Closing debate, Steele said that if Oklahoma does not change the way it administers Medicaid, in a few years the program's needs will consume the entire state budget, particularly with the growth of the state's aging population.

He said Medicaid's costs have risen from $1.5 billion in 1999 to $3.5 billion currently.

The bill now goes to the Senate.

Marie Price is a special projects/ enterprise reporter for The Journal Record.

Source: Journal Record - Oklahoma City

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