President's Message

Posted on: 5/16/25

Over the past four months, OHA has been warning the membership about the potential impact Medicaid cuts could have on our patients, communities, and most certainly, our member hospitals.

In January, OHA launched the Coalition to Protect Healthcare in Oklahoma, and since then we’ve been messaging at the grassroots level, through broadcast, print and social media, and at public and OHA member meetings.

In March, we commissioned and shared the results of a comprehensive public opinion survey on the public attitudes towards Medicaid. The results of that survey demonstrated overwhelming support for Medicaid and most especially Medicaid expansion. On next week’s episode of our podcast, Inside the 1581, we go through the public opinion survey and the important components we have used in a strategic communications around Medicaid cuts.

Meanwhile, the American Hospital Association has been doing heavy lifting in our nation’s capital to persuade members of Congress of the potential catastrophic impact $880 billion in Medicaid cuts could have on America’s hospitals.

Well, I’m pleased to say that the hard work here in Oklahoma and in Washington. D.C. has begun to pay off.

This week, the House Energy and Commerce Committee, which has primary jurisdiction over Medicaid in the U.S. House of Representatives, met in a marathon 24-hour session to arrive at cuts to fund the continuation of the Trump tax cut.

The most significant cuts that hospitals feared the most, including elimination of Medicaid expansion, eliminating hospital directed payments, creating a per capita Medicaid cap, or changing the federal government’s matching commitment to fund Medicaid, were not part of the package the committee approved.

That’s good news, but what did pass the committee still could lead to more than 10 million people losing their health insurance.

What does the Energy and Commerce Committee package look like for Oklahoma? Well, unfortunately, if the House proposal becomes law, our direct payment program payments would freeze at the state-submitted 2026 levels. What does that mean? First of all, the tax that we rely on to fund our directed payments would be frozen at the 4% level. Meanwhile, other states with higher tax rates and more opportunity to grow their programs would be permitted to continue with their higher rates.

This policy would restrict our ability to innovate further in our Medicaid program and would eventually find our payments eroding due to higher costs and inflation with no opportunity to adjust the DPP.

Also included in the package is an overall dollar limit on our direct payment program. In other words, the current draw down of the federal funds we receive today and our distribution back to hospitals would be frozen at the time the federal law is enacted. Again, this cap on our provider tax and cap on the funds distributed to hospitals will make it difficult to keep up with market changes.

In addition to these payment reforms, changes in policy regarding eligibility determinations, as well as work requirements, will certainly reduce the number of Americans covered under expansion. Some of the concerns about changes to the eligibility process could also lead to patients dropping off the Medicaid roles. 

What are the next steps? The House will continue to move their proposal through their body and send it to the Senate. The Senate Finance and Tax Committee will then have an opportunity to make further changes. So, we still have a way to go before any of this becomes law.

If you recall, when Congress last chose to repeal and replace the Affordable Care Act, that final vote didn’t happen until late summer when John McCain voted no.

OHA, as well as our peer hospital associations and the American Hospital Association, believes we can make some further adjustments to the budget reconciliation act. We will certainly be looking to gain more flexibility and prevent Oklahoma from being unfairly treated by not allowing our state to modify our directed payment program or expand our provider fee like other states.

We still have much to do and our messaging must continue to reinforce the importance of ensuring Oklahomans have access to healthcare coverage. Our state should be given the ability to further innovate and appropriately fund the care delivered by hospitals.

There are other battles on the horizon that will likely come after the budget, including 340B and perhaps site neutral payment changes. So, stay tuned and stay engaged.

Aligning with OHA and the Coalition to Protect Healthcare in Oklahoma is essential to our messaging and our field unity. We’ve already seen the value of coming together in our member communications and we appreciate your support of this work. When we stay united and work together, we can be successful at improving health and healthcare in Oklahoma.

Rich Rasmussen
President & CEO