OKLAHOMA CITY – Representatives of two of the state’s largest tribal nations spent Wednesday morning outlining reasons why state lawmakers should expand Medicaid coverage in Oklahoma.
The presentation, given at a meeting of a bipartisan legislative working group, was the latest in a series of information sessions for lawmakers. For several months now, lawmakers have met and wrestled with the idea of Medicaid expansion in Oklahoma.
Melanie Fourkiller, a policy adviser for the Choctaw Nation, and Melissa Gower, a senior policy analyst for the Chickasaw Nation, made the presentation.
Both tribes offer health care services to their members. Nationwide, the Indian Healthcare System covers 12 service areas including Oklahoma City, which has the largest active patient population in the nation. Information released by the tribes show that the Oklahoma City HIS serves more than 375,000 patients.
The HIS system includes eight hospitals and 53 health centers.
Per capita spending for IHS patient services, Fourkiller said, was $4,078 — substantially less than the $9,726 spent per person nationwide. Oklahoma’s IHS level of need funding is about 39 percent. Fully funding the system would require more than $37 billion.
Though lawmakers have discussed several ways to increase Medicaid coverage, one proposal would extend coverage for Oklahomans at 133 percent of the federal poverty level, up from the current 100 percent of the federal poverty level. Materials released by Fourkiller and Gower used the 133 percent figure.
Fourkiller said expanding Medicaid in Oklahoma would “increase the federal matching rate from the current rate of 62 percent for traditional Medicaid to 90 percent for services for the expansion population.”
“For instance we had mothers and children, some of those obstetric services that could move from 62 percent federal match to 90 percent federal match and that makes a savings to the state,” she said.
Fourkiller said expansion would also decrease the cost for uncompensated care, or instances when an individual without any health care insurance is treated in a hospital emergency room.
“If the FPL (federal poverty level) were raised 133 percent you’re capturing a lot of the working poor in Oklahoma that can’t afford insurance, even on the market place,” she said. “There may be some low cost insurance out there that some folks can get if they are really destitute but if you’re a worker in Oklahoma you still may not be able to afford that.”
Along with the Choctaw and Chickasaw Nations, at least one other manor tribe in Oklahoma – along with the National Congress of American Indians – has announced announced support for some type of Medicaid Expansion.
In a media statement, the Muskogee (Creek) Nation encouraged its citizens to “exercise their right as an Oklahoma voter by signing the petition to place State Question 802 on the upcoming 2020 ballot by hosting the petition in MCN Health facilities.”
Oklahoma, the Muskogee Nation said, has second highest rated for uninsured residents in the U.S.
“Those most affected are low-income working adults in service-industry jobs. They cannot afford coverage but are over the current rate guidelines to qualify for Medicaid. Expanding would provide health insurance for an individual who makes less than $17,000 a year or $29,000 for a family of three,” the tribe’s media statement said.
In 2014, the National Congress of American Indians passed a resolution urging the 26 states which did not expand Medicaid coverage to do so.
‘The NCAI hereby supports the expansion of Medicaid in the remaining states to address the limited resources and lack of services provided to chronically under served populations such as American Indian and Alaska Native Communities when the decision comes before the Governors and state legislatures,” the resolution said.
‘The NCAI hereby supports the expansion of Medicaid in the remaining states to address the limited resources and lack of services provided to chronically underserved populations such as American Indian and Alaska Native Communities when the decision comes before the Governors and state legislatures,” the resolution said.
Lawmakers are under pressure to doing some type of Medicaid expansion. This spring the Oklahoma Supreme Court threw out a challenge to an initiative petition – supported by the state’s medical community – that would expand Medicaid coverage in Oklahoma.
Petition supporters are currently gathering signatures.
