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Outcry over Medicaid copays is unwarranted

by The Oklahoman Editorial Board Published: June 23, 2014

SOME Oklahomans on Medicaid could face higher copays next year. Critics are loudly decrying this possibility. Yet we doubt most Oklahomans will lose sleep worrying that a recipient might have to pay $4 for medicine.

The Oklahoma Health Care Authority, which administers Medicaid, faces a shortfall due to federal funding cuts. To help make up the difference, agency officials may raise the copayments that patients pay. Oklahoma Policy Institute, a think tank that promotes increased government spending, believes this is unacceptable. In a release issued last week, the institute declared higher copayments “would shift costs onto the poorest and sickest Oklahomans, make it harder for doctors to effectively treat patients, and cause greater health problems that will mean higher costs later.”

Sounds bad until you notice the actual copays under consideration. Currently, Medicaid patients have no copay for preferred generic drugs. Other copayments range from just 65 cents to $3.50 based on the total cost of the drug. Under the OHCA proposal, those copays could jump all the way … to $4. A Medicaid patient’s copayment for a doctor visit might go from $3 to $4.

OK Policy warns those small sums may be “more than many can afford.” Yet we suspect most Oklahomans, viewing these proposed copayments, have a far different reaction: That’s all?

In 2009, reports that 73 percent of individuals with insurance coverage through an employer faced a copayment for a doctor visit. The average cost was $21.53.

Keep in mind, those citizens are forking over their hard-earned money for a copayment and at least a share of their premium. That latter expense is one Medicaid patients don’t face. reports the average premium costs for a family insurance policy rose 62 percent from 2003 to 2011. The expense jumped from $9,249 per year to $15,022. Although employers covered an average of 74 percent of the cost, the remainder comes out of an employee’s paycheck. Under Obamacare, those expenses are expected to only increase.

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by The Oklahoman Editorial Board
The Oklahoman Editorial Board consists of Gary Pierson, President and CEO of The Oklahoma Publishing Company; Christopher P. Reen, president and publisher of The Oklahoman; Kelly Dyer Fry, editor and vice president of news; Christy Gaylord...
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