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I realize all news is bonkers right now, but this situation has been ESPECIALLY bonkers, so let's dig in! https://twitter.com/OKPolicy/status/1253025795100073986
ICYMI (or forgot, because time currently has no meaning): in mid-March, the state posted its proposal to create all sorts of barriers to Medicaid access for public comment. Work requirements, premiums, and block grants, oh my!
As you may recall, this is also when COVID-19 made its way here. Providers were scrambling to prep, patient advocates were trying to make sure the people they serve could get what they needed, and rest of us were either working from home or had lost our jobs
THERE WAS KIND OF A LOT GOING ON
Inexplicably, the state decided to put up its incredibly consequential, first-of-its-kind proposal for public comment just as all of this was hitting
They didn't have to! It's a self-imposed timeline! But they did anyway
They didn't have to! It's a self-imposed timeline! But they did anyway
Remarkably, advocates stepped up. The state Medicaid agency added more virtual public meetings, and ultimately more than 600 people participated. The agency got at least 2700 comments on their proposal (we know because they used our portal) - again, in the middle of a pandemic
We asked the state to either withdraw the waiver or extend the comment period. Oklahoma's block grant proposal includes elements that no other state has never done before (because it hasn't been allowed, because it's not super legal, but still). This deserves time and attention
As you might have guessed from the headline, the public comment period was neither suspended nor extended. Public comments ended on Wednesday. The state held an "informational session" on how public comments had shaped the waiver on Monday
If you are thinking, "Golly, that's fast turnaround for something with that level of public engagement!" you're not wrong. OHCA made some very small changes, updating the managed care section, clarifying information about how the proposal applies to American Indians...
...and made a tweak to when applicants' coverage starts.
That's not nothing. But it's also not what most of the comments the agency received were about.
That's not nothing. But it's also not what most of the comments the agency received were about.
Oklahoma is proposing to cut Medicaid coverage for people who don't meet a work requirement. It wants to charge very, very poor people symbolic premiums that result in coverage loss. It wants to try out a new and extremely risky financing mechanism
And instead of taking the unprecedented level of engagement on this into account - again, in the middle of a global health crisis - the state made a few tweaks over a few days and sent it off to the feds, where we get to do this whole public comment thing again in a few weeks
IN THE MIDDLE OF A GLOBAL HEALTH CRISIS
There's no reason to be rushing this! There's no ticking clock! Thousands of people gave the state their time, attention, and expertise in responding to this waiver. The state owes it to them to take their concerns seriously and give them the consideration they deserve
That is...not what appears to be happening
