Accepting Federal Funds for the Uninsured

The U.S. Supreme Court ruled that the Affordable Care Act (ACA) was constitutional, but states could not be coerced into expanding Medicaid with the threat of withholding all existing Medicaid funding. In Oklahoma, Medicaid expansion would provide insurance coverage for approximately 180,000 adults who have incomes below 133 percent of the federal poverty limit. 

Governor Fallin announced in November 2012 that Oklahoma would not expand Medicaid eligibility as part of the ACA. Governor Fallin also called for a comprehensive consultant study by the Leavitt Group to develop an Oklahoma Plan to address health care for the low income uninsured in Oklahoma. The recommendations of the Leavitt Group were presented to the Oklahoma Health Care Authority Board on June 27, 2013.

Oklahoma hospitals will experience $2.4 billion in Medicare cuts between 2014 and 2022. These cuts are part of the ACA that were to be offset by a 94 percent insurance coverage participation rate. If Oklahoma chooses not to accept federal funds to provide health care coverage for low income adults, hospitals will still experience these cuts but will not be able to benefit from the offset that would occur on the state level. It is important to note that federal law requires emergency treatment and stabilization to be provided to patients regardless of ability to pay.

The OHA has a longstanding history of supporting efforts to decrease the number of uninsured in Oklahoma. Annually, hospitals provide more than $500 million in the cost of uncompensated hospital care for patients who are uninsured. Expanding Medicaid would have the potential to reduce the number of uninsured in Oklahoma by at least 28 percent, from a current estimate of 638,500.

Oklahoma routinely accepts federal funds for defense, transportation, education, and health care needs. Oklahoma is the third highest state in federal disaster declarations, according to FEMA. It is important for Oklahomans to understand that uncompensated care is currently paid for by everyone who pays their hospital bill or health insurance premium. OHA does not believe that it is possible to provide coverage for low income childless adults without federal participation.