OKLAHOMA CITY (AP) — A plan to test privatizing the management of health care services to the poor in Oklahoma narrowly passed the state Senate on Thursday over the objections of opponents concerned it will lead to lower reimbursement rates for doctors and hospitals.
The Senate voted 25-21 for the Oklahoma Medicaid Reform Act of 2014, giving it just enough votes to secure passage. The bill now heads to the House, where it is expected to undergo changes.
Sen. Kim David, R-Porter, the bill’s author, said the goal is to establish a pilot managed-care program in which Medicaid recipients receive health care services from a private company that contracts with the state. Currently, the Oklahoma Health Care Authority is the state agency that oversees health care services for the more than 800,000 Oklahomans, mostly children, who qualify for the state Medicaid program called SoonerCare.
“What I’m trying to do is privatize it, where it needs to be,” David said. “Let’s do a pilot study and see if we can do it better in the private market.”
Both Democrats and Republicans voiced concerns about adding another layer of bureaucracy to the health care system, especially because the goal of the private company, typically a health maintenance organization, or HMO, is to earn a profit. Several members brought up Oklahoma’s failed experiment at managed care in the 1990s, which resulted in fewer providers offering services to Medicaid patients.
“If you create a middleman, all you’re going to do is divert money away,” said Sen. Ron Sharp, R-Seminole. “We don’t need a pilot program, because this pilot already crashed and burned back in the 1990s.”
But David argued that more than three dozen other states currently operate some kind of managed-care system and that Oklahoma can apply some of the best practices that already have proven successful.
Although the bill successfully passed the Senate, a procedural maneuver ensured it must return for final passage after it is considered in the House.
Rep. Doug Cox, an emergency room physician from Grove and one of House Speaker Jeff Hickman’s top advisers on health care matters, said he has concerns about the idea of managed care, which is opposed by doctors and hospitals alike.
“There’s a lot of times those two groups can’t agree on anything,” said Cox, R-Grove. “Whenever those two groups oppose it, that kind of makes you wonder if we’re going down the right road.”
Cox says the Health Care Authority already operates a managed-care program.
“They put the patient’s primary physician as the manager of their care. That’s the way it should be,” Cox said. “The doctor and patient should work closely together for the benefit of the patient’s health, and that’s the model that the Health Care Authority has used.”