Oklahoma – Work Never Conquers All

Oklahoma – Work Never Conquers All

On May 27, 2020, HHS opened a 30-day federal comment period on Oklahoma’s proposed Medicaid demonstration project. Comments are due June 27, 2020!

Instead of Sooner Care, a better name for Oklahoma’s proposal would be Oklahoma’s state motto — “Work Conquers All”. Oklahoma is taking things a bit too far by trying to impose work requirements for people to keep Medicaid. Oklahoma’s proposal includes other harmful provisions as well: premium payments for very low income individuals; payments for non-emergency use of the Emergency Department; and eliminating retroactive coverage, Non-Emergency Medical Transportation, hospitals’ ability to enroll Medicaid individuals, and Early and Periodic Screening, Diagnostic, and Treatment services for 19 and 20 year olds. Oklahoma is doing this even though the courts have found these proposals illegal.

Additionally, Oklahoma is requesting permission to implement a “per-capita cap” for its Medicaid expansion population. This is based on guidance issued by HHS. By their design, per-capita caps limit spending and reduce access to care. Since changing Medicaid’s financing is not included in the parts of the Medicaid statute that states can request to waive, Oklahoma’s request is illegal.

So why should you still submit comments? Because this is the first time a state is requesting a per capita cap under HHS new guidance. Assuming the proposal is challenged in court, the court will look at all the comments when making its decision. It’s really important to build a strong “administrative record” by submitting comments.

Top 5 suggestions for submitting comments

Here are our “top five” suggestions for submitting comments:

  • Tell a story — talk about the personal experiences of you, your family and friends who receive Medicaid or would have trouble meeting a requirement to work;
  • Be unique – it’s the details you know that are important, try to add your story rather than just repeat others’ comments;
  • If you have it, include data and evidence from publications or studies;
  • Ask others who might be impacted to share their stories; and
  • Do not let perfect be the enemy of the good.

Comments do not need to be perfect! The important thing is to raise the full range of threats from Oklahoma’s waiver proposal. If you do not have time to find a study or flawlessly construct an argument, it is still better to submit comments and raise the issues to HHS than to submit nothing.

Cutting thousands of people from Medicaid, especially in the middle of a pandemic, doesn’t meet the law’s purpose of furnishing medical assistance. Oklahoma’s proposal is heartless and cruel, and wed to cutting low-income individuals and families from Medicaid and instead using tax dollars to support an array of private and powerful interests.

The current fight is about Oklahoma Medicaid. But more states are waiting in the wings, itching to attach per capita caps, block grants and similar obstacles to their Medicaid programs.

You can get more details about the importance of comments in our publication — Do My Comments Really Matter? Demystifying the Public Comment Process.

Comments are due June 27, 2020. Please submit your comments here.

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