Adds 350,000 new lives to the private health insurance market. ⢠Reduces SoonerCare enrollment by 17%. ⢠Insures 175
DRAFT The Medicaid Rebalancing Act of 2020 The Medicaid Rebalancing Act of 2020: Restores provider rates to at least 86% of Medicare fee schedule as soon as possible Adds 350,000 new lives to the private health insurance market Reduces SoonerCare enrollment by 17% Insures 175,000 Oklahomans who are currently uninsured Reduces the uninsured rate by 35% Preserves the SoonerCare provider network Protects access to quality health care in rural and urban areas Strengthens Oklahoma’s behavioral health and substance abuse systems Supports Drug Courts and Mental Health Courts and protects Crisis Centers How it works: The Act has three parts: 1. Create a new Insure Oklahoma program option The new program covers adults 19-64 who have incomes below 133% of the federal poverty level, offers them a choice of commercial insurance plans, and requires that they pay premiums based on their income on a sliding scale. The program also includes personal responsibility financial incentives for health lifestyle choices, required preventative screenings, etc. Incentive dollars may be used for premiums, co-payments or deductibles and are portable when the individual leaves the program. Impact: Insures 175,000 Oklahomans who currently have no benefits Costs $100 million state dollars to be matched with federal dollars 2. Move some SoonerCare members to the private health insurance market. Some current SoonerCare members with incomes above 133% of the federal poverty level are moved to the commercial market where they are eligible for tax credits to support premium costs. This occurs when maintenance of effort requirements expire on Oct. 1, 2019. Impact: Moves 175,000 pregnant women and children to private insurance plans Saves $60 million in state funds 3. Restore provider rates back to the current 86.5% of Medicare as soon as possible. Impact: Requires additional state funding from the options below Reduces uncompensated care burden for hospitals and providers
