Health Care officials have pushed lawmakers to use all available options to halt Gov. Kevin Stitt’s plan to privatize Medicaid, but House leaders say they aren’t willing to use the state budget as a last-resort negotiation tool.
Three weeks have passed since the House of Representatives voted in favor of Senate Bill 131, which would halt a plan for the Oklahoma Health Care Authority to contract with four private insurance companies to deliver Medicaid benefits in the state.
Driven by fears that managed care will bring dramatic financial instability and lowered health outcomes, health care providers are pressuring the state Senate to also take a vote on the bill before the end of the legislative session May 28. The Senate has not yet scheduled a hearing for the bill. Stitt would most likely veto the bill if it pases, which lawmakers would then have to override.
If the bill isn’t approved, opponents of managed care say there is another way to stop privatization: The Legislature could simply not fund the state’s contracts with insurers.
“House and Senate leadership can place limits on agency budgets through the appropriations process, including not funding the governor’s managed care scheme,” said Wes Glinsmann, director of the Oklahoma State Medical Association.
The Oklahoma Health Care Authority awarded the $2 billion managed care contracts in January with the provision that if no funding was provided by the Legislature, the contracts would become void.
The Legislature can tell state agencies how to spend at least some of the funding they receive by writing a limits bill, which outlines how lawmakers want to see funds spent, said Rep. Kyle Hilbert, R-Bristow.
But that process requires approval from lawmakers, and Hilbert said if Senate Bill 131 fails or isn’t heard by the Senate, any other bill prohibiting the Health Care Authority from funding the managed care contracts would likely also fail.
“Essentially, that bill would be doing the same thing that Senate Bill 131 already does,” Hilbert said. “(Senate Bill 131) is the only bill, in my mind, that could stop those managed care contracts. … If it doesn’t cross the finish line, then I don’t see the likelihood of another similar measure prohibiting the Oklahoma Health Care Authority from expending those funds on those contracts being successful.”
House Speaker Charles McCall, R-Atoka, believes the passage of State Question 802 last summer, which added language to Oklahoma’s constitution mandating Medicaid expansion, requires the Legislature to move ahead with one of the two proposed plans.
“It’s policy at the end of the day, and whichever one prevails, we’re going to fund it,” he said.
McCall and Hilbert voted in favor of Senate Bill 131.
Rep. Marcus McEntire, the House author for Senate Bill 131, said the House has stated its opposition to managed care, but he won’t support the budget being used as a negotiation tool.
“We don’t want to use the budget as that lever. Our objective is to get a budget, not to blow it up over a policy,” said McEntire, R-Duncan. “If I can’t win people over with the idea and the merits of the policy, then I just can’t get it done.”
Senate leadership hasn’t said as decisively that they would be against telling the Health Care Authority how to spend appropriated funding but indicated a mandate like that may be unlikely.
A spokesperson for Senate Pro Tem Greg Treat, R-Oklahoma City, said no decisions were finalized and the Legislature has until the end of the legislative session on May 28 to consider bills.
Senate Appropriations Chairman Roger Thompson, R-Okemah, said he’s never seen lawmakers tell the Health Care Authority how to dispense care, and he doesn’t think he wants to start now.
“I’m not sure I want to get into the position that tells them how to do their job,” Thompson told The Frontier. “At this time, there is no discussion for a limits bill on how to direct health care through the Health Care Authority. Can that discussion come at a later moment? Sure.”
But Hilbert said if Senate Bill 131 fails, the House will focus on implementing the governor’s managed care plan.
“At that point, then the state of Oklahoma is moving forward with the governor’s plan,” he said. “And I’m going to do everything I can to make sure that plan is successful because we’ll have 1.2 million Oklahomans who utilize Medicaid and we need to make sure we’re doing the best we can in the services that we have.”