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Oklahoma will submit Medicaid expansion request Friday, Gov. Kevin Stitt says - 3/6/2020

The Oklahoma Health Care Authority on Friday will submit to the federal government a state plan amendment seeking to expand Medicaid in Oklahoma as soon as this summer.

"The Health Care Authority has the authority to send in the paperwork to expand, and we’re going to get that out on Friday," Gov. Kevin Stitt told The Oklahoman on Thursday.

The state plan amendment will get the ball rolling for Oklahoma to seek federal approval to expand Medicaid.

When a state wants to change its Medicaid program, the state must submit to the Centers for Medicare and Medicaid Services a state plan amendment for review and approval. The amendment is separate from the Healthy Adult Opportunity waiver Stitt has expressed an interest in seeking.

As Stitt seeks to move forward with expanding Medicaid on July 1 through his SoonerCare 2.0 plan, he's still in talks with the Legislature on how to fund the expansion.

If Oklahoma expands Medicaid, the state will have to cover 10% of the costs, which consultants for the governor have estimated will be around $150 million annually. The federal government would cover the other 90%, which will be around $1 billion annually.

Stitt said he thinks he's close to a funding deal with the House, Senate and hospital industry, which may have to pay higher fees to help cover the state's share of the expansion. The state doesn't have to submit a funding proposal as part of the state plan amendment, Stitt said.

One of the sticking points appears to be the Supplemental Hospital Offset Payment Program, a hospital fee that may be increased to fund the expansion. Saying Oklahoma hospitals wouldn't have time to budget for a fee increase that would take effect this year, the Oklahoma Hospital Association pushed back against the increase.

Stitt wants to raise the fee to 4%, the highest point allowable under current state law. But Senate lawmakers have indicated they don't want to raise the fee higher than 3.25% because the fee, which is based on Medicaid expenses, fluctuates annually.

"We’re going to be talking about how you fund it, whether it’s SoonerCare 2.0 or if the state question passes," Stitt said. "We’ve got to have this discussion. Let’s just talk about it, let’s put this to bed and move on."

Stitt proposed his SoonerCare 2.0 expansion plan as an alternative to State Question 802, which seeks to expand Medicaid in Oklahoma by inserting it into the state constitution. Unlike the state question, Stitt seeks to impose modest premiums and work requirements on those who would receive Medicaid benefits under an expansion.

Supporters of SQ 802 are pushing Stitt to set an election date for the question. Together Oklahoma, the advocacy group for the Oklahoma Policy Institute, delivered to the governor's office Thursday a petition signed by hundreds of Oklahomans asking Stitt to set a date.

"Full Medicaid expansion through the state constitution is the cleanest, most transparent way to expand health care coverage in Oklahoma," she said in a statement. "It’s time for the governor to do his job by announcing an election date so Oklahomans can decide best how to proceed."


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