Oklahoma Gov. Mary Fallin last year rejected Medicaid expansion as envisioned under the federal Affordable Care Act because she feared it would cost too much.
On Thursday, state health officials authorized a $500,000 contract for a consultant to figure out how much it will cost for Oklahoma to go its own way.
Utah-based Leavitt Partners is now tasked with determining how best to provide health care coverage for as many as 200,000 low-income Oklahomans who would have qualified for Medicaid coverage under the Affordable Care Act, also known as Obamacare.
“The first part is to take a look at the program as it is now, to do a historical perspective on the program, almost like an evaluation piece,” said Carter Kimble, spokesman for the Oklahoma Health Care Authority, which approved the contract unanimously.
“The second piece is a way to kind of look at our future going forward and see if there are some state-based solutions out there to improve outcomes, contain costs and things like that,” Kimble said. “Really, the idea is ultimately to reduce the number of uninsured, provide quality access to health care and address rising costs, because it's a big piece of the state budget.”
A report released this week by the Kaiser Commission on Medicaid and the Uninsured shows expanding the program to the level proposed under Obamacare could have cost the state $689 million over the next 10 years. The state currently spends more than a billion dollars a year on Medicaid.
The federal government would have paid $3.6 billion over seven years, including 100 percent of costs for the first three years.
Expanding Medicaid also could save the state $205 million in uncompensated hospital care costs, according to the report.
Fallin supports the decision to hire a consultant, her spokesman, Alex Weintz, said on Thursday.
“The governor supports pursuing Oklahoma-based solutions to making health care more accessible and affordable,” Weintz said, adding that spending $500,000 now to develop more affordable solutions is the right thing to do.
Leavitt Partners was founded in 2009 by former Utah Gov. Mike Leavitt. Half of the contract approved Thursday will be paid for with federal matching dollars, according to its stipulations.
The firm has been working with several other states that rejected Obamacare funding to develop an Internet-based health care exchange that would put Leavitt in charge of handling day-to-day operations and leave regulatory control in the hands of the states.
Expanding Insure Oklahoma — which provides matching funds to small businesses and their employees for the purpose of purchasing private insurance — is one of several options Leavitt will explore, Kimble said.
Leavitt also will look to see if the state can get a federal waiver to partially expand other health programs like SoonerCare, Oklahoma's version of Medicaid.
Kimble said the state potentially could expand its own programs and operate outside the boundaries of its current Medicaid contracts with a federal waiver.
Residents who are not included under any Medicaid expansion or additional alternative would be required to purchase insurance from a private provider, according to the stipulations of Obamacare.