Governor Kevin Stitt's proposal to retool Oklahoma's Medicaid system closed its 30-day public input period on Wednesday, but some Oklahomans say the disruption caused by the coronavirus pandemic made that timeframe inadequate for such a consequential policy change.
"I don’t think it’s in any way reasonable to expect that providers, patients, advocates, or even the state Medicaid agency that is running the comment period had the capacity to really give this the time and attention it deserves," said Carly Putnam, health care analyst and policy director at the Oklahoma Policy Institute.
"It's big policy at the best of times, and these are not the best of times."
Stitt's proposal would initially expand Medicaid in full, but after one year would impose restrictions, such as work requirements and premiums, and cap the amount of federal funding the state's program could receive.
"To pull it back in that second year feels like a classic bait and switch," Putnam said.
Putnam said the public input process was also interrupted by the social distancing measures implemented across various levels of government to combat the coronavirus pandemic.
"I'm totally sympathetic to the Health Care Authority," Putnam said, "but in-person public meetings typically have a lot of advantages. You can see who is in the room, you can request clarification and follow up, you can see which questions are being answered and which ones aren't. And it's a really important way to get all of that into a public record."
Putnam said that Oklahomans will have another opportunity to make their voices heard, "probably in about a month," when the proposal is received and processed by the federal government, which will require another 30-day comment period.
Putnam said it's likely, based on other states' legal battles over Medicaid expansion, that the governor's proposal would eventually be struck down in the courts due to its work requirements and premiums — but that could take years.
"I really wish we didn't have to take such a long road to get there when Oklahomans need that health care right now," said Putnam.
Stitt said in a January address alongside Trump administration officials in Washington, D.C., that his Medicaid scheme would "capture our total federal dollars under Medicaid in a way that is more stable and accountable."