News Release
January 8, 2009
Contact: Jo Kilgore, Public Information Manager, (405) 522-7474.
OHCA Board Takes a Look Back at SoonerCare, Expands Insure Oklahoma
OKLAHOMA CITY – The Oklahoma Health Care Authority’s board heard during their meeting Thursday an overview of the most comprehensive report ever conducted on Oklahoma’s SoonerCare (Medicaid) program. Board members also passed a rule that will open the Insure Oklahoma program to larger businesses and college students, upon approval by Gov. Brad Henry.
Mathematica Policy Research Inc., recently concluded their comprehensive evaluation of Oklahoma’s SoonerCare 1115 waiver program. The group studied the program as it has evolved since 1993, when the OHCA was created. Mathematica studied the history of the program to assess the impact of key policy and implementation decisions on enrollment trends, access to care, provider participation, health of members and costs to Oklahoma. The state’s program was compared with those of other state Medicaid programs and national trends.
Representatives from the group presented key findings to the board. Included in those findings is that SoonerCare has improved coverage for Oklahoma children with enrollment of eligible children increasing 36 percent from 2000 to 2006. The group reported that 90 percent of all MDs in the state, both specialists and primary care providers, had contracts with SoonerCare Choice. They also noted that preventable hospitalizations dropped among adults by 24 percent in urban areas and 15 percent in rural areas from 2003 to 2006.
Oklahoma is providing more for less, according to the study. They found that Oklahoma’s Medicaid costs per member were below the national average between 1996 and 2005. Medicaid accounted for a smaller share of the state budget in Oklahoma between 1996 and 2005 than the national average and 19 comparison states, they noted. The group also noted that the OHCA sets a high standard for public reporting and accountability.
“It’s a great compliment when a leading, national consulting firm says your agency is a ‘textbook example’ of how to accomplish an initiative. But more importantly, the report gives us an outside-looking-in view of our program and agency which will help us shape the future,” OHCA CEO Mike Fogarty noted.
In other action, the board approved an emergency rule to expand the Insure Oklahoma employer size from 50 employees to 250 and to include full-time college students aged 19 to 23. The rule allows the agency the flexibility to phase in the number of employees, giving the smaller businesses the first shot at enrolling in the program.
The Oklahoma Legislature called for increasing employer size in early 2007. However, since the program is funded using state tobacco tax money matched with federal funds, the agency had to seek federal approval through a waiver amendment. The Centers for Medicare & Medicaid Services (CMS) approved parts of the waiver amendment request effective Jan. 1. The rule now goes to the governor for final approval.
If signed by the governor, the OHCA expects to begin taking applications from businesses with 99 and fewer full-time employees on March 1. The agency will evaluate the uptake of the program and can increase the size as needed. According to the 2006 Oklahoma Employment Security Commission quarterly census of employment and wages, 2,770 additional businesses fall into the 50- to 99-employee size and will become eligible to participate in the program.
Full-time college students will also be able to apply for the program under the rule change. Income will be determined based on the student’s FAFSA (Free Application for Federal Student Aid), and premiums will be based on the student’s income.
Employees and college students whose household income is below 200 percent of the federal poverty level may qualify for the program. Additional information is available at www.insureoklahoma.org or by calling 1-888-365-3742.
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