After attending the Oklahoma Health Care Authority Open Forum at Kiamichi Technology Center on April 7, I am more certain that the governor’s plan is not going to be good for anyone except these private insurance companies. It certainly will not be good for Oklahoma taxpayers.
The OHCA is the administrator of the SoonerCare program. Governor Stitt wants to give the lion’s share of the program to 4 private insurance companies to run. SoonerSelect will be a $2 Billion program in the first year. Currently, OHCA administers the program for approximately 5% administrative fee. These 4 private insurance companies are allowed by federal law to charge up to 15% or $300 Million.
In addition, OHCA has no plans to lay off any of their 600+ employees after transitioning 75-85% of their workload to these insurance companies. These employees will be retained to provide quality oversight of the insurance companies. I’m having a hard time understanding why they would give their book of business to someone to run, pay them $200 million more annually than it is costing them to run it themselves and then have to retain all of their employees to provide oversight of those companies. If these companies can’t be trusted to comply with OHCA’s contract, why are they getting in bed with them? Plus, there is absolutely no guarantee that there will be any improvement in overall quality of care.
Make no mistake, these insurance companies are in this to make a profit, a really big profit. By federal law, they are allowed a 15% profit off the top in administrative fees. Next, Oklahoma will pay these companies a flat rate for each person that they get to enroll on their plan. OHCA’s own actuarial study estimates that there will be a 40% decrease in hospital utilization when these insurance companies start managing Sooner Care patients care. Whatever they can save by denying care means bigger profits for the insurance companies. Most important is that there is no proof that private insurance companies managing healthcare improve quality of health. Seven of the ten states ranking lowest in health outcomes have Medicaid programs managed by private insurance companies.
When you step back and look at the big picture, it makes no sense. The healthcare providers in this state do not support this program. Our state legislators do not support the program. Seventeen Oklahoma medical associations do not support this program. This program is going to cost Oklahoma hundreds of millions of dollars more than we currently pay each year to support the SoonerCare program. However, Governor Stitt continues to push for implementation. When your Governor refuses to listen to the experts who have boots on the ground and defies the will of the people, it makes me wonder where we are headed.
The day after the Open Forum, Governor Stitt lashed out at state legislators for not supporting his plan, calling the current plan a page from the Biden playbook. Personally, I’m not a Joe Biden fan and take exception to the governor’s characterization of those that oppose him on this issue. Actually, I voted for Governor Stitt and support a lot of his agenda, but not this issue. As I see it, sending hundreds of millions of Oklahoma dollars out of state each year with absolutely no guarantee that there will be any return on investment is very similar to Joe Biden’s recent Stimulus Plan where he sent hundreds of billions of dollars to foreign countries without a guarantee of a return on investment.
Bob Carter, CEO
Eastern Oklahoma Medical Center