By Oklahoma Institute for Child Advocacy CEO Joe Dorman
SoonerCare, or Oklahoma’s Medicaid program, is designed to provide health insurance to children in low-income families, low-income seniors, people with disabilities and several other high-needs populations. It is the largest insurer in Oklahoma and an essential part of our social safety net. The people on SoonerCare cannot afford private insurance; if they lose their coverage, they will go uninsured.
That’s why it was so upsetting to many of us at the Oklahoma Institute for Child Advocacy (OICA) when the federal government handed down a new edict designed to knock people off the SoonerCare rolls. The new rule says that if the Oklahoma Health Care Authority cannot reach a SoonerCare recipient at their address on file, then they will lose their coverage after 30 days.
The intent of this policy is to prevent fraud. But the reality is that many SoonerCare residents must rely on government-funded health care precisely because they live in unstable and uncertain conditions, including their housing. Some move between the homes of friends and relatives; some are fleeing abusive relationships; others have recently lost jobs and have moved to look for work. Of course, many of these people have one or more children, who are also eligible for SoonerCare. These families are likely to be hard to find and are therefore the most at-risk of losing their coverage.
The numbers are not insignificant. Following a recent mailer by the Oklahoma Health Care Authority (OHCA), which administers SonerCare, about two percent of those within the system had their mail returned. Upon further review, only about half of those individuals had an email on file. The remaining one percent might sound small, but it represents tens of thousands of Oklahomans who would lose their insurance if an update is not provided. Most of them are children.
Although this policy was vigorously debated and has its opponents within the OHCA, the conclusion reached by agency leaders is that the federal directive is mandatory. However, I am happy to say that their staff has been making every effort to contact each client and inform them about the impending loss of coverage if address updates are not provided.
Over the past month, a task force of board members, staff from the OHCA, and one citizen was formed to review options. I was pleased to be selected as the citizen representative for this task force and three very positive meetings were held to review options. It was good to see so many people raise various points, all working toward the same goal of ensuring validity of the member’s information and the need to find ways to communicate this new requirement.
Going forward, following the approval of this adopted rule by Governor Stitt, the Oklahoma Health Care Authority will have multiple points of attempted contact with individuals to help them preserve coverage for themselves and their family members who qualify. Following the return of a mailed letter, there will be an attempt to contact the person through the email they have on file. Should this not work, then a series of phone calls will be made to notify the client to contact the office so as to provide a new mailing address. There will also be an effort made to educate health care providers about this new requirement and the need for their patients to verify their mailing address in the OHCA patient profile.
In addition, other state agencies and partner organizations that deal with individuals who might qualify are asked to help provide awareness about this new OHCA requirement, such as local schools, homeless shelters or the Domestic Abuse Unit through the Attorney General’s office. In the future, options such as opt-in text updates might also be considered.
This is a good example of level heads working through a problem and finding better solutions to address the situation. I appreciate the Health Care Authority involving the OICA in these processes as we worked together to preserve health insurance for tens of thousands of Oklahomans, including many children.
If you are interested in learning if you qualify for SoonerCare, or if you need to update your address on file, please go to OKHCA.org
And lastly, I hope all our readers have a happy and safe Fourth of July!