Editor's Note: Some clarifications and updates were made to this story on Monday, April 5 at 6 p.m.
On June 30, 2020, the Oklahoma Medicaid Expansion Initiative, State Question 802, passed by a majority vote (50.49% yes and 49.51% no) to expand Medicaid eligibility to adults age 19-64 whose income is 138% of the federal poverty level.
The expanded coverage begins on July 1, 2021 with the federal government paying 90 percent of the costs and the state of Oklahoma the other 10 percent. Once the Oklahoma Health Care Authority receives approval from CMS and secures funding, the agency will move forward with enrolling new members in the expansion population.
To qualify for Medicaid expansion, single adults must have an annual income of $17,796 or less and for families the income level is $36,588 or less.
On October 1, 2021, SoonerCare populations of children (including foster children), the new adult expansion population and pregnant women will transition to SoonerSelect, the new managed care program, according to the health care authority.
Companies in the managed care program (MCOs) include Blue Cross and Blue Shield of Oklahoma, Humana Healthy Horizons, Oklahoma Complete Health, and United Healthcare. Dental care is available through DentaQuest, Liberty Dental, and MCNA Dental.
“MCOs use value-based payment models that incentivize, empower, and reward providers for the quality of care. The managed care model, unlike the fee-for-service approach, is built to bring together desperate parts of the delivery system. Modern Medicaid managed care enables Oklahoma to deliver higher quality care and improved health outcomes for Medicaid recipients, while managing health care costs.” (Medicaid Health Plans of America)
An estimated one million Oklahomans are now eligible for the state Medicaid program.
The Health Care Authority says people who qualify for SoonerSelect but do not choose a plan will be placed into a plan. Then in 90 days they can change to another plan. It is mandatory for Oklahoma residents to be signed up for SoonerSelect.
The authority said the Medicaid application process will be open to the expanded population starting July 1.
There is some opposition to the plan.
A coalition of health care groups is asking the Oklahoma Supreme Court to halt Stitt’s plan to outsource care for most of the state’s Medicaid recipients. At this point, the Oklahoma Legislature has not voted on managed care nor funding for it. The lawsuit asks the court to find that the Health Care Authority went beyond its authority in making deals with four insurance companies to provide managed care, reported Carmen Forman of The Oklahoman.
Plaintiffs in this suit include Oklahoma State Medical Association, Oklahoma Dental Association, Oklahoma Osteopathic Association, Oklahoma Society of Anesthesiologists, and Oklahoma Chapter of the Academy of Pediatrics.
John Tidwell, Directory of Americans for Prosperity, said, “It will overwhelm our already struggling state budget and hurt those that the program was intended to help and lead to government cutting core services we rely on and increase taxes.”
On Thursday, March 26, members of the Oklahoma Health Care Authority, formed a panel at the High Plains Technology Center in Woodward to provide information about SoonerSelect.
Following information from each panel member, attendees in the audience asked questions and voiced concerns, as did those watching the meeting on the internet via ZOOM.
Key points from the panel included the following:
• SoonerSelect has the potential of hiring 2,000 more employees to manage the program.
• SoonerSelect of 2021 was developed after lessons learned from the previous privatized Medicaid in 1993.
• Provider contact information is available on the Oklahoma Health Care Authority web site (oklahoma.gov).
• Literature about the new SoonerSelect plans will be sent out in August across Oklahoma.
• Patient information with the new program will be included on the state’s portal of data for easy access and privacy.
• Oklahoma Oversight will handle concerns of patients in dealing with providers and/or Medicaid plans.
• New Medicaid insurance cards will be mailed out after plans are selected by each individual and family.
Both the Medicaid and SoonerSelect are under the management of the Oklahoma Health Care Authority. The website is oklahoma.gov/ohca and the office phone number is 405-522-7300.