Educating Oklahomans about coverage options is key to avoiding a health care catastrophe

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More than 300,000 Oklahomans are expected to lose Medicaid coverage over the next nine months, and increasing awareness will be the only way to avoid a potential health care catastrophe. This adds up to more than 623,000 uninsured in Oklahoma.

The state must reduce enrollment in its Medicaid program, known as SoonerCare, because of the end of continuous Medicaid coverage provisions in the pandemic-related Public Health Emergency Act. States must now revert to pre-pandemic Medicaid eligibility rules.

The Medicaid “unwinding” began April 30. Nationwide, as many as 24 million are expected to lose Medicaid coverage, according to estimates from the Kaiser Family Foundation.

The Oklahoma Health Care Authority is taking steps to notify those who must be dropped and using a well-thought-out, tiered approach to winnowing their Medicaid rolls. The authority deserves praise for its approach to mitigate a difficult situation as much as possible. The agency’s steps include sending multiple letters, identifying those most and least likely to be impacted, and conducting an analytics deep dive into the needs and access of the former SoonerCare enrollees.

First to go will be those who have been enrolled but have never had a claim, and whose income is too high for Medicaid eligibility. Next will be those who have another source of insurance, such as through a spouse or employer. The following group will be single Oklahomans who don’t have children younger than 5 in the household (it’s worth noting that children’s Medicaid eligibility is higher than adults’, meaning some kids could be on SoonerCare even when their parents don’t qualify). After these groups are removed, the cuts become deeper.

Getting the word out about coverage options is tough, but critical, particularly for employers, who will bear increased costs from adding employees to their insurance plans or having uninsured employees miss work or underperform because of illness.

With the potential for nearly 1 million uninsured individuals in Oklahoma, connecting uninsured and underinsured Oklahomans with clinics and specialists, as well as helping them navigate which options are best for them, will be of critical importance. According to the Kaiser Family Foundation, it takes nine to 12 months for someone who has lost Medicaid to be reconnected to health care services. Oklahoma can ― and should ― be able to beat this small statistic through the extensive partnerships statewide. Among those are the 92 free and charitable clinics that partner with the Health Alliance for the Uninsured.

These clinics stand ready to help meet the growing need. Their goal is to improve Oklahomans’ health by giving them an alternative to going to the emergency room for primary care ― an extremely expensive and ineffective long term option.

The first line of defense will be employer-provided insurance. For those who can’t afford it or whose employers don’t provide it (particularly contract and part-time employees), Health Insurance Marketplace plans and tax credits will be lifesavers. For those who still can’t find affordable coverage, such as undocumented immigrants, and those who make too much for Medicaid, but too little to be able to afford a Marketplace plan, there is a free or charitable clinic within a 30-minute drive for 9 in 10 Oklahomans. These clinics are the unsung heroes of our health care safety net. They are primarily volunteer-run and offer services for free or on sliding scales. They are often the last, best stop before someone heads to an emergency department. They are there for exactly the sort of situation the state faces.

Taken together, these options can blunt the impact of the Medicaid unwinding. But employers must educate their employees, who might not know what’s out there or understand the deadlines they may face when seeking alternate insurance. It’s a responsibility employers didn’t seek, but one they must embrace for the well-being of their workers.

It’s not too late to avoid a health care catastrophe, but the clock is ticking.

Jeanean Yanish Jones

Jeanean Yanish Jones

Jeanean Yanish Jones is executive director of the Health Alliance for the Uninsured.

This article originally appeared on Oklahoman: Guest: With Medicaid cuts, can Oklahoma avoid health care disaster?

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