MORE than two months have passed since the projected implementation date for expansion of a state health insurance premium assistance program. This is one time a state agency can’t be blamed for dragging its feet.
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Instead, the fault lies with the Bush administration’s Centers for Medicare and Medicaid Services (CMS). Perhaps the Obama administration, at Gov. Brad Henry’s urging, will get CMS off the dime.
Henry and the Legislature agreed to expand the Insure Oklahoma program to make more Oklahomans eligible. Coverage was to be extended to adults with incomes of up to 250 percent of the federal poverty level and businesses that employ up to 250 employees. Also mandated was coverage of children in households earning up to 300 percent of the federal poverty level.
The legislation came with a hitch: It required a waiver from CMS, a process that’s never quick but also never as time-consuming as this has been. Inexplicably, the waiver request is in its 15th month of consideration in Washington. That makes it the longest review process ever endured by the Oklahoma Health Care Authority.
Not only has the wait been long, it’s been "fraught with unlegislated policy changes at CMS,” the authority says. OHCA Executive Director Mike Fogarty said he has responded to more than 80 written questions from CMS and had nearly 30 conference calls in an attempt to get the waiver approved.
This is likened by Fogarty to hitting a moving target: Just when one CMS concern is satisfied, another arises. The changes were supposed to be implemented by Sept. 1.
The Insure Oklahoma program provides state funds to be matched by small businesses and their employees to buy private health insurance coverage. It’s an innovative approach emphasizing the free market rather than government health care. In a state with an estimated 600,000 uninsured residents, efforts to decrease that number are critical.
The state hasn’t been lax in addressing the problem, but it can’t do what the legislation requires until CMS signs off.
Fogarty notes that U.S. Health and Human Services Secretary Mike Leavitt hailed Oklahoma’s outreach to the uninsured in an early 2007 visit to the state. Yet the federal agency with the mission of partnering with state Medicaid programs can’t seem to give a yes or no answer to the waiver request.
Leavitt called Insure Oklahoma "a very fruitful idea.” Seems to us this fruit should have been picked months ago.
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Lawrence, I don't believe that it's the suing that has much to do with it. I think it has a lot more to do with the profit of each insurance company. Have you ever looked at it? It's difficult to dig up numbers, but when you know that BCBS of California is netting over a billion dollars PROFIT each year, it's very difficult to feel sorry for each individual company, in every state, especially when they refuse to cover care for the people purchasing their programs.
As for this editorial, I agree with Sallie, with the way the state spends money, I don't blame them for the stall. Of course, that's the pot and the tea kettle, don't trust the feds either.
Think the State and Federal government would be more beneficial if they could roll back all these price increases from the health care industry. What could will it do to increase insurance coverage when you are basically give the health care industry the combination to the safe. Prices are too high now for the services provided. Limit the right of a consumer to sue and reduce prices to what they were 15 to 20 years ago. Most people could probably afford heath insureance then.
With our State Legislators taking those designated funds for other purposes, I don't blame the feds for stalling on the program unless they get an agreement from our state not to steal the funds.
Welcome to FEMA for health care. This looks like the feds (ab)using policy so they don't have to sign off on a program they find objectionable. No valid reason to deny it, just an agency needing more time to find a reason to say no.
Concerned, Central Oklahoma - Nov 18, 2008 at 10:25 am
This program is funded by smokers and you, DOK promote the expansion of the program while the legislators take from it for purposes other than health care. By all means lets expand it and open the door for even more funding that can be taken whenever convenient.ppffffttt
Insure Oklahoma is a program available to businesses in the state with 50 or fewer employees. The state pays 60 percent of the monthly premium, while the employer and employee pay the rest. Participating businesses offer one of the private insurance products approved by the Insure Oklahoma program. The program is funded by Oklahoma’s tobacco tax and federal matching funds.
Legislators this year used $108 million from the special health fund to balance the $7.1 billion budget for the fiscal year that began July 1. The fund was set up when voters in 2004 approved a tobacco tax increase.
The fund had a surplus of about $115 million; during the last fiscal year about $18 million more came into the fund than was spent. Most of the $108 million taken from the fund — about $70 million — was given to the Oklahoma Health Care Authority to replace lost federal funding.
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As for this editorial, I agree with Sallie, with the way the state spends money, I don't blame them for the stall. Of course, that's the pot and the tea kettle, don't trust the feds either.
Insure Oklahoma is a program available to businesses in the state with 50 or fewer employees. The state pays 60 percent of the monthly premium, while the employer and employee pay the rest. Participating businesses offer one of the private insurance products approved by the Insure Oklahoma program. The program is funded by Oklahoma’s tobacco tax and federal matching funds.
Legislators this year used $108 million from the special health fund to balance the $7.1 billion budget for the fiscal year that began July 1. The fund was set up when voters in 2004 approved a tobacco tax increase.
The fund had a surplus of about $115 million; during the last fiscal year about $18 million more came into the fund than was spent. Most of the $108 million taken from the fund — about $70 million — was given to the Oklahoma Health Care Authority to replace lost federal funding.