Jonathan Small | January 29, 2016
Continued Health Care, Welfare Reforms Will Help the Most Vulnerable
In 2015, Oklahoma lawmakers passed a number of important health care reforms. But the work must continue. Oklahoma policymakers have the opportunity to continue to empower patients and medical providers.
Additional State and Education Employee Health Insurance Reforms
In 2015, lawmakers passed reforms to modernize the state’s health insurance program for state and education employees. The enacted reforms would allow the state to save more than $95 million once fully implemented. The ball is now in the court of the administrators of the state’s health insurance plan to implement the reforms. Given the speed at which local governments and the private sector have fully implemented reforms for bundled pricing and health care price transparency, lawmakers should not tolerate delay. If administrators for the state don’t have the expertise to implement the reforms quickly, lawmakers should pass legislation at the beginning of session to require administrators to contract with plan administrators who can implement the reforms quickly. The state’s budget hole demands it.
Other opportunities remain. Lawmakers should remove from statute regulations that stifle the option of state employees to purchase private health insurance with state funds. Lawmakers should create parity between the mandates for the state’s self- insured plan and the mandates for participating private plans. Private plans shouldn’t be required to provide higher benefit or actuarial values than the state plan. This change will save employees and the state millions of dollars.
Additional Medicaid Reforms
In 2015, lawmakers began the effort to implement reforms to our state’s Medicaid program, a program in which total spending now exceeds state spending on common education and higher education combined. The program now has more than one million Oklahomans enrolled. Further reforms that must be implemented include appointment of the Oklahoma Health Care Authority director by the governor. The current Medicaid program is unsustainable. New ideas and a focus on empowering patients and improving patient outcomes must be the focus and culture of the agency. This kind of accountability can only happen with direct appointing authority by the governor. The improvement of the Oklahoma Department of Human Services is a real-world example of how successful a change like this can be for taxpayers and for those who depend on services.
Implementation of enrollee eligibility audits is also a must. A number of states, including Illinois, are finding that thousands of Medicaid enrollees who are not eligible are in fact receiving Medicaid benefits. This costs states millions of dollars. If we care about the most vulnerable, about preserving a sustainable Medicaid program for the truly needy, we will reform the program so that it’s available for them and doesn’t overburden taxpayers.
Further Reforms to Help the Most Vulnerable
Oklahoma should move to reform food stamp benefits to deter fraud. A growing reform option is the placement of picture identifications on food stamp debit cards. This reform should be adopted in Oklahoma and will make sure that services are preserved for the truly needy.
In addition, a number of lawmakers are proposing a common-sense reform to protect those with disabilities from burdensome taxation. This change would allow developmentally disabled residents to start tax-free savings accounts similar to the Oklahoma 529 College Savings Plan accounts. Current Oklahoma tax law would result in a disabled Oklahoman being disqualified for benefits if he or she were to receive an inheritance or other crucial assets. The United States Congress passed the Achieving Better Life Experience (ABLE) Act a number of years ago to address this challenge. The law provided states with the ability to set policy as it relates to each state. Oklahoma has not yet established a policy to allow for the protection of a reasonable level of asset accumulation to take place without taxation. Lawmakers should work to fix this problem so that families are not prevented from empowering their own disabled family members.
Lawmakers should also work to promote pro bono health care. Health care, with its ever-soaring costs, is one of the most significant causes of bankruptcy across the United States. Nonprofit and free-market-related health care clinics are working to solve this challenge by encouraging medical providers to volunteer hours to care for those who cannot afford to pay much for their care. As I discuss in a forthcoming paper, lawmakers should create a program that authorizes a tax credit for a medical provider who provides care to certain qualified individuals who are unable to pay for their own care. In addition, civil protections and licensing provisions should be modified so that providers can provide “free care” without fear of lawsuits and so free temporary medical clinics like Remote Area Medical can operate within the state. Now more than ever, Oklahoma policymakers must continue to pursue health and welfare reforms. Taxpayers, and the most vulnerable Oklahomans, deserve it.
Jonathan Small, C.P.A., serves as OCPA’s president. Previously, he served as a budget analyst for the Oklahoma Office of State Finance, as a fiscal policy analyst and research analyst for the Oklahoma House of Representatives, and as director of government affairs for the Oklahoma Insurance Department. He holds a B.A. in Accounting from the University of Central Oklahoma and is a Certified Public Accountant.
Jonathan Small, C.P.A., serves as President and joined the staff in December of 2010. Previously, Jonathan served as a budget analyst for the Oklahoma Office of State Finance, as a fiscal policy analyst and research analyst for the Oklahoma House of Representatives, and as director of government affairs for the Oklahoma Insurance Department. Small’s work includes co-authoring “Economics 101” with Dr. Arthur Laffer and Dr. Wayne Winegarden, and his policy expertise has been referenced by The Oklahoman, the Tulsa World, National Review, the L.A. Times, The Hill, the Wall Street Journal and the Huffington Post. His weekly column “Free Market Friday” is published by the Journal Record and syndicated in 27 markets. A recipient of the American Legislative Exchange Council’s prestigious Private Sector Member of the Year award, Small is nationally recognized for his work to promote free markets, limited government and innovative public policy reforms. Jonathan holds a B.A. in Accounting from the University of Central Oklahoma and is a Certified Public Accountant.