News Release

October 9, 2014

OHCA Contacts: Jo Kilgore - (405) 522-7474, Jennie Melendez - (405) 522-7404   

OHCA presents SFY16 budget request 

OKLAHOMA CITY – The Oklahoma Health Care Authority (OHCA) board was presented with the agency’s State Fiscal Year (SFY) 2016 budget request at their October 9 meeting. In addition to the agency’s base funding of approximately $953 million in state funds, OHCA is requesting an additional $163.6 million needed to maintain the existing program. This includes replacement of lost federal dollars, four percent program growth, a federal mandate for an in-house administrative law judge and replacement of one-time carryover funds—representing the top four budget priorities for the agency.   

The Federal Medical Assistance Percentage (FMAP) used to determine the amount of federal matching funds for state Medicaid expenditures will continue its downward trend for Oklahoma by decreasing in SFY2016. The rate will decrease from 62.30 percent to 61.25 percent and create a need for $39 million in additional state funds. This follows a reduction of 1.72 percentage points in SFY 2015. FMAP is the federal funding formula based on a state’s per capita income relative to that of other states using a three-year rolling average.  

The request also includes $14.4 million to cover children who qualify for SoonerCare through the Children’s Health Insurance Program (CHIP). CHIP provides an increased match rate of 72.88 percent for services provided to children from 133 percent to 185 percent of the Federal Poverty Level, and is currently before Congress for possible reauthorization. If the program is not reauthorized, these children will remain in the SoonerCare program, but will receive the regular match of 61.25 percent. However, if CHIP is reauthorized through Federal Fiscal Year 2019, the match rate will increase to approximately 96 percent and the OHCA’s request for additional state funds will decrease by $42 million. 

A projected growth rate of four percent in the SoonerCare (Oklahoma Medicaid) program would require an additional $45 million. One-time carryover funding of $61 million makes up a large part of the agency’s current SFY15 budget, and must be replaced in SFY16.  

In addition to maintenance of the existing program, OHCA is asking for almost $102 million to restore provider rates to pre-SFY 2010 levels. The agency cut rates for most provider groups by 3.25 percent in SFY 2010 and an additional 7.75 percent on July 1.  

The agency is also asking for an additional $7.6 million to increase Disproportionate Share Hospital (DSH) funding to the maximum allowable level. Federal law requires state Medicaid programs make DSH payments to qualifying hospitals that serve a large number of Medicaid and uninsured individuals. 

The remaining budget request items total approximately $1.5 million and include advanced genetic testing for developmental delays, contract expenditures, software and removal of monthly limits for certain medications. The request includes a total of 11 priorities totaling an additional $275 million in state funds.  

About OHCA

The Oklahoma Health Care Authority (OHCA) administers Oklahoma’s Medicaid program, known as SoonerCare, and Insure Oklahoma, a premium assistance program funded by tobacco tax revenue. SoonerCare works to improve the health outcomes of Oklahomans by ensuring that medically necessary benefits and services are responsive to the health care needs of our members. Qualifying Oklahomans include low-income children, pregnant women, seniors, the disabled, those being treated for breast or cervical cancer and those seeking family planning services. All must meet income guidelines. Insure Oklahoma assists qualifying adults and small business employees in obtaining health care coverage for themselves and their families. OHCA works with our current 818,100 members, our statewide network of 39,614 health care providers and numerous state and local partners to promote   responsible health care service utilization, healthy behaviors and improved health outcomes. For more information, visit www.okhca.org or www.insureoklahoma.org.