Stitt Proposes "SoonerCare 2.0" Based on New Medicaid Capped-Funding Program

Jan 30, 2020

Gov. Kevin Stitt wants Oklahoma to go all-in on the Trump administration’s new funding approach to Medicaid.

"I am committing to positioning Oklahoma as one of the first states to seek the advantages of the Healthy Adult Opportunity initiative as we pursue SoonerCare 2.0," Stitt said Thursday at a Centers for Medicare and Medicaid Services event in Washington, D.C.

Stitt is proposing a health plan he’s dubbed "SoonerCare 2.0" to apply for additional but capped federal funds to cover able-bodied adults under 65. It is his alternative to a citizen-driven effort to expand Medicaid.

Stitt said he’s heard Oklahomans want improved access in rural areas, shorter wait times for patients in need and quality care.

"Oklahomans want their federal tax dollars to be returned to the state and put into good use, but efforts to do this through amending our constitution to force Medicaid expansion are wrong and will be ineffective and will fail to fix our problems," Stitt said.

States that apply for the Healthy Adult Opportunity program can include any sort of Medicaid program waiver previously approved by the feds. Stitt said work requirements will be part of his plan.

"With flexibility, we will seek to establish moderate premiums to prepare members for the responsibility of transitioning to private health insurance coverage," Stitt said.

Oklahoma Policy Institute Policy Director Carly Putnam said charging a premium for SoonerCare defeats its purpose of providing affordable coverage to low-income people.

"If you can’t pay your premium, then you can’t get your health care, and that means you don’t get the care you need. And for this group, which, I mean, we’re talking people who are making $12,000, $15,000 a year at the high end — we know that just keeps them from getting health care," Putnam said.

While Stitt did not lay out the whole plan, he said the focus of SoonerCare 2.0 will be rewarding outcomes and performance rather than paying fees for services.

Putnam said Stitt's overall proposal is risky because the Healthy Adult Opportunity program makes legally questionable changes to Medicaid’s financing system.

"The administration has said that they expect them to be challenged in court, and as we’ve seen when other states have tried to pursue similar proposals, what that really means is that the state gets tied up in litigation for years and the people who need health care don’t get it," Putnam said.

The Center on Budget and Policy Priorities said accepting capped funding leaves states on the hook if their costs go up outside of a disaster or health emergency. Groups like the AARP, the American Cancer Society Action Network and the Federation of American Hospitals oppose a capped-funding system.

Putnam said what Oklahomans want is full Medicaid expansion.

"More than 300,000 Oklahomans signed the ballot petition after waiting and waiting for the state to do something. Oklahomans know what they want, and I really am not sure that this is it," Putnam said.

Roughly 100,000 Oklahomans don’t have health insurance because they make too much for Medicaid but too little for federal marketplace subsidies.