Could be­come first state to scrap Med­i­caid en­tirely

Modern Healthcare - - NEWS -

AN OK­LA­HOMA MAN RE­CENTLY DROVE MORE THAN AN HOUR TO REACH COM­MU­NITY HEALTH CON­NEC­TION, a fed­er­ally qual­i­fied health cen­ter in Tulsa, be­cause he is unin­sured, and it was the clos­est place he could go for di­a­betes care.

The man, in his early 60s, had been a fire­fighter. Dr. Sarah-Anne Schu­mann, med­i­cal di­rec­tor of the clinic, told him he should get a rou­tine screen­ing for colon can­cer, but he de­clined.

He told Schu­mann, “I don’t want you to screen me for colon can­cer, be­cause if you find it I don’t have a way to treat it with­out health in­surance.” She knew he had a point. Around that time, the clinic CEO re­ceived an e-mail in­form­ing him that all state fund­ing to fed­er­ally qual­i­fied health cen­ters was be­ing elim­i­nated, ef­fec­tive im­me­di­ately. Days later, the state Med­i­caid pro­gram pro­posed a 25% cut in provider pay­ments.

If ap­proved, that will send even more pa­tients to places like Com­mu­nity Health Con­nec­tion, which is now fight­ing to keep its doors open and its em­ploy­ees paid.

Nico Gomez, CEO of the Ok­la­homa Health Care Au­thor­ity, said the state could be­come the first to scrap Med­i­caid en­tirely in the next few years, leav­ing about 800,000 low-in­come Ok­la­homans with­out cov­er­age.

But there is good news, Schu­mann said. A state Se­nate com­mit­tee re­jected a bill that would have cut Med­i­caid el­i­gi­bil­ity to any non­preg­nant, able-bod­ied adult younger than 65, elim­i­nat­ing more than 100,000 ben­e­fi­cia­ries. It would have mostly af­fected sin­gle moth­ers mak­ing less than $9,000 a year.

“It’s sad what we have to call good news,” she said.

Ok­la­homa’s gen­eral rev­enue fund has been de­pleted by re­duced oil and gas pro­duc­tion rev­enue. The state also lost more than $1 bil­lion by shav­ing the top in­come tax rate to 5% from 6.65%. Ok­la­homa is al­ready among the worst states for health­care ac­cess be­cause of high poverty, low in­surance cov­er­age rates, and not enough doc­tors and nurse prac­ti­tion­ers. Its health out­comes con­sis­tently rank in the bot­tom five among states in na­tional stud­ies.

While some have sug­gested an in­fu­sion of fed­eral funds through Med­i­caid ex­pan­sion, the GOP-led State­house is not likely to ap­prove the idea.

The pa­tient said, “I don’t want you to screen me for colon can­cer be­cause if you find it I don’t have a way to treat it with­out health in­surance.” DR. SARAH- ANNE SCHU­MANN

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