Senator: Legislature should not 'pre-empt' Medicaid expansion vote

Sen. Ron Sharp

OKLAHOMA CITY — Senate lawmakers this week quietly passed a measure to expand Medicaid that critics say will be funded by squeezing many of the state’s already cash-strapped hospitals.

Opponents also complained lawmakers only approved Gov. Kevin Stitt’s SoonerCare 2.0 Medicaid expansion plan because they’re trying to pre-emptively thwart a citizen-led expansion question that will appear on the June 30 election ballot. State Question 802 calls for traditional Medicaid expansion.

State Sen. Ron Sharp, R-Shawnee, opposed the measure. It is a little late in the game for a legislative remedy to distract the vote after nearly a decade of bucking calls to expand Medicaid.

“There are voters anxiously awaiting to vote ‘yes,' and there are those anxiously awaiting the opportunity to vote ‘no,'” Sharp said. “I believe that since it is a referendum, the Legislature should not pre-empt that vote.”

SoonerCare 2.0 involves using a controversial block grant program, charging premiums and establishing work requirements. Critics believe SoonerCare 2.0 is likely to face years of legal challenges, ultimately delaying health care access for hundreds of thousands of Oklahomans.

While SoonerCare 2.0 could expand Medicaid access to as many as 220,000 state residents, individuals will lose their coverage if they don’t pay premiums and work, volunteer or attend education programs at least 80 hours a month.

Under both plans, the state must come up with roughly $150 million to fund Oklahoma’s share. The federal government pays 90% of the expansion costs.

Sharp also said he had concerns about the funding mechanism and how it would impact hospitals.

Lawmakers want to modify the Supplemental Hospital Offset Payment Program, or SHOPP fee, by increasing the assessment rate on hospitals to 4%. Fiscal estimates indicate the fee hike will raise $134 million next budget year to pay for Stitt’s expansion proposal.

The self-assessment allows hospitals to maximize federal Medicaid matching funds. It is meant to supplement, not supplant, state Medicaid funding, officials said.

“Senate Bill 1046 is unacceptable to Oklahoma hospitals,” said Patti Davis, president of Oklahoma Hospital Association.

Davis said due to the COVID-19 pandemic, the cratering of the oil industry, rising unemployment and a predicted second wave of the deadly virus, it is critical to expand Medicaid as soon as possible.

But, she believes the measure is flawed.

“If hospitals are to be asked to fund the bulk of the cost of Medicaid expansion at this unprecedented time for the health care industry, we need some safeguards in the bills,” she said. “Hospitals need protection against the harmful effects of commercial managed care. Also missing from SB 1046 is a provision allowing SHOPP to serve as a backstop for the state share of expansion.”

State Sen. Frank Simpson, R-Springer, said the measure would allow for Medicaid expansion starting July 1. It increases the fee on hospitals by about 1.7%. He voted in favor of the measure.

He said there are protections built into the proposed law for small hospitals and those that may experience hardships in meeting the new fees. Simpson said 65 currently hospitals pay the assessment.

But everything would fall apart if voters approve the state question.

“The entire statute that we’re changing would no longer be relevant if 802 passes,” Simpson said. “My understanding is if 802 passes… (the entire thing) is canceled and we’re back to square one.”

The bill still needs to clear the House.

Stitt said Thursday he hadn’t yet seen the bills to fund his own proposal.

He didn’t say whether he’d support them.

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