Latest news with #SoonerCare
Yahoo
21-05-2025
- Health
- Yahoo
The number of uninsured Oklahomans could soar if Medicaid funding is rolled back
As a health care leader, my No. 1 concern has always been helping patients receive the care they need, when they need it. That's why I'm greatly concerned about the $880 billion in Medicaid budget cuts Congress is currently considering. Amid a year already marked by uncertainty and change, about 1 million Oklahomans who rely on Medicaid (also known as SoonerCare) to meet their health care needs face additional worries about whether they will be able to maintain access to the providers they know and trust. Many of these patients live in rural communities where small or critical access hospitals are essential. Less than 10% of Oklahomans remain uninsured thanks to current Medicaid policies. But that number could soar if Medicaid funding is rolled back. This will not only affect patients — it will affect all of Oklahoma, as it could cost up to $2.5 billion in additional costs to the state. Despite already having a nearly $40 million shortfall for the upcoming fiscal year, Oklahoma may have to draw down our $1.3 billion emergency fund to manage this unexpected expense. The state could also consider raising taxes or reducing funds from other programs to allocate funds toward Medicaid support. If the state eventually does roll back Medicaid funding because of shifting cost responsibilities, hundreds of thousands of Oklahomans could be displaced from their current health care coverage. In the absence of SoonerCare, many will likely forgo coverage rather than seeking private insurance. This lack of coverage puts a tremendous burden on our hospitals and health systems — especially those in rural areas. Opinion: Veterinary medicine is important to Oklahoma's health. We can't fall behind. For rural hospitals, a loss to Medicaid funding could result in an up to 15% reduction in revenue used to provide hope and healing for our most vulnerable community members, resulting in worse health outcomes, delayed treatments and increased mortality rates. This could then force these hospitals to cut essential services and employees or even close their doors, weakening the backbone of local economies by eliminating jobs and forcing residents to travel long distances for medical care. Having served in health care for over 20 years, I feel strongly that it is more important than ever to amplify the voices of Oklahomans around these important issues. This is not the future I want for Oklahoma. We cannot afford to lose Medicaid funding. As legislators consider cuts, we as Oklahomans must consider how this may impact communities around the state and advocate for what we want. Call your federal representatives today and tell them to preserve Medicaid funding. If you are interested in staying up to date about how this issue could impact health care in our state, go to a coalition focused on protecting and improving sustainable access in Oklahoma. Jeremy Jones is the chief executive officer of Arbuckle Memorial Hospital in Sulphur. This article originally appeared on Oklahoman: Oklahoma could see a $2.5B tab if Medicaid funding is cut | Opinion
Yahoo
08-05-2025
- Business
- Yahoo
Oklahoma AG Drummond seeks to recover lost CVS Medicaid funds
OKLAHOMA CITY (KFOR) – Oklahoma Attorney General Gentner Drummond announced his office has initiated efforts to recover any Oklahoma taxpayer funds that CVS Pharmacy fraudulently obtained as Medicaid reimbursements. According to Drummond's Office, the complaint filed on April 14 seeks to hold CVS responsible for violating the state's False Claims Act. Additionally noting, CVS charged Medicaid programs higher prices than the 'usual and customary' to the general public. 'We're citizens!': Oklahoma City family traumatized after ICE raids home, but they weren't suspects The Oklahoma Medicaid program, called SoonerCare, covers medical costs including prescription drug costs for Oklahomans with limited income, says Drummond's Office. 'Oklahoma taxpayers deserve to see that their money is spent fairly and appropriately,' Drummond said. 'I am committed to fighting corruption and will work to hold accountable anyone who tries to harm Oklahomans.' The complaint in part highlights, from 2016 until at least 2022, CVS knowingly concealed lower prices offered to the public and misrepresented its usual and customary prescription drug prices to fraudulently increase Medicaid reimbursements, said Drummond's latest press release. Drummond office added, the complaint includes the following states Indiana, Connecticut and Massachusetts. To read the full complaint click here. *This story is developing Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
21-04-2025
- Health
- Yahoo
A fifth of Americans are on Medicaid. Some of them have no idea
An emergency room nurse tends to a patient at a Houston hospital. Experts worry that Medicaid's complexity can make it hard for people to see how potential cuts to the program's funding could impact not just insurance coverage, but also could result in longer wait times at hospitals, fewer services offered and, in some cases, hospital closures (). Some Americans who rely on Medicaid to pay for their health care don't realize their insurance is funded by that very program, which congressional Republicans are looking to shrink. One reason is that state programs aren't always called 'Medicaid.' Many states have rebranded their programs with consumer-friendly names such as SoonerCare in Oklahoma, Apple Health in Washington, Medi-Cal in California or TennCare in Tennessee. And nearly all states now use private insurance companies such as UnitedHealth or Blue Cross Blue Shield to run their Medicaid programs. That means Medicaid enrollees may hold an insurance card and paperwork with the name of a commercial insurance company. 'We toss around terms like 'Medicaid,' but we see so many of our patients not having [insurance cards or] anything that describes or uses the word 'Medicaid,'' said Dr. Adam Brown, a Washington, D.C.-based emergency physician and founder of a health care strategy firm. 'People oftentimes do not realize either that they have it, or know the value of what it does.' Medicaid is the health insurance program for people with low incomes or certain disabilities. About 72 million people, or about a fifth of all the people living in the United States, are enrolled. It operates with state and federal funding, but every state has the freedom to choose how to run its program, within federal rules. As a result, Medicaid is a sprawling patchwork of programs that can confuse lawmakers and even top health officials, not to mention the average beneficiary. Robert F. Kennedy Jr., now secretary of the U.S. Department of Health and Human Services, incorrectly described basic elements of Medicaid and seemed to confuse it with Medicare during his January confirmation hearing before Congress. Republicans in Congress are considering proposals to slash hundreds of billions of dollars from federal Medicaid funding as they look to offset trillions in tax cuts proposed by President Donald Trump. The specifics of the Medicaid cuts are still being hammered out. But any reductions to federal Medicaid spending would shift those costs to states, which would likely be forced to end services or cut coverage for certain groups of people. 'Part of the problem is when we hear people talk on television or hear lawmakers talk, there are many people that don't make the connection that they themselves are on [Medicaid] or that their hospital is very much dependent upon the dollars that come from Medicaid,' said Brown. 'Calling it one thing and branding it something very different, that makes it challenging for people to understand the connection or the value in the product that they actually have.' About 3 in 4 people who have Medicaid are enrolled in managed care organizations (MCOs), according to the latest national data. Most of these are private plans operated by companies such as UnitedHealth Group and Centene. But the branding from these companies can distance recipients from the fact that their care is paid for with public funds. When Brown worked in emergency medicine, he had many patients who had insurance through Medicaid. 'There were times they would show me their card and it would have commercial branding, like a Blue Cross Blue Shield,' he said. But as they talked, 'I noticed there was a lack of understanding that they were on a Medicaid-supported or state/federal-supported program.' Millions of people who are enrolled in Medicaid mistakenly believe they're uninsured, Dr. Ben Sommers, a Harvard health economist and physician, told Stateline. 'It is a long-standing issue that got worse during the pandemic,' he said. He and fellow researchers found that the gap between the number of people who have Medicaid and the number who think they have it jumped during the pandemic, to about 18.5 million people. This was due to a lack of public understanding about a COVID-era rule that granted continuous Medicaid coverage to people without requiring them to re-enroll, researchers found. Sommers expects the gap will eventually return to pre-pandemic levels, or nearly 6 million people. 'That's still a lot of people who don't think they're in Medicaid but who are,' he said. There are also some uninsured people who enroll in Medicaid when they show up at an emergency room or clinic needing care. Most providers will check for Medicaid eligibility if a person doesn't have another form of insurance. People who become Medicaid beneficiaries that way may not realize it's Medicaid paying for their care, Sommers said. Physicians, public health experts and advocates worry that the confusion over Medicaid is affecting public debate over funding cuts. From a public health perspective, Sommers said, 'It's not a huge problem if people think they have one type of insurance and misclassify it, as long as they're getting care. 'Politically, it can be tricky if people don't recognize they have Medicaid and they're trying to weigh in on policies that affect Medicaid.' Conservatives have long argued for reducing the reach of Medicaid. They say the program is too expensive and that its expansion under the Affordable Care Act, also known as Obamacare, diverts too much money toward able-bodied adults and away from the more vulnerable populations it was originally intended to help. But despite the controversy surrounding Medicaid, the program is extremely popular. More than 3 in 4 people view Medicaid favorably, including nearly two-thirds of Republicans, according to a January tracking poll from KFF. In focus groups conducted in January by KFF, no Trump voters and few Harris voters said they were aware of proposals to cut federal Medicaid dollars, and some Trump voters said they didn't think Trump would follow through on the cuts. Brown said that despite confusion, most Medicaid patients he encountered were aware their insurance came through a government program. But he said it can still be hard for people — including those with private insurance — to make the connection between Medicaid funding cuts and their local hospitals or other services. 'We oftentimes frame this [debate over Medicaid funding cuts] as 'People will lose their health insurance,' and that is true,' Brown said. But 'the constituencies affected are not just the people who have Medicaid.' Less funding for Medicaid, or an increase in the number of people without insurance, would harm people with any kind of insurance, he said. It could lead to longer wait times at hospitals, fewer services offered and, in some cases, hospital closures. 'One of the important parts about democracy is people being educated about what their representatives are voting for or against, and also how to advocate for yourself,' Brown said. 'If you don't fundamentally understand or fully grasp the benefits you have, then it's harder to advocate.' Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@
Yahoo
09-04-2025
- Health
- Yahoo
A fifth of Americans are on Medicaid. Some of them have no idea.
An emergency room nurse tends to a patient at a Houston hospital. Experts worry that Medicaid's complexity can make it hard for people to see how potential cuts to the program's funding could impact not just insurance coverage, but also could result in longer wait times at hospitals, fewer services offered and, in some cases, hospital closures. () Some Americans who rely on Medicaid to pay for their health care don't realize their insurance is funded by that very program, which congressional Republicans are looking to shrink. One reason is that state programs aren't always called 'Medicaid.' Many states have rebranded their programs with consumer-friendly names such as SoonerCare in Oklahoma, Apple Health in Washington, Medi-Cal in California or TennCare in Tennessee. And nearly all states now use private insurance companies such as UnitedHealth or Blue Cross Blue Shield to run their Medicaid programs. That means Medicaid enrollees may hold an insurance card and paperwork with the name of a commercial insurance company. 'We toss around terms like 'Medicaid,' but we see so many of our patients not having [insurance cards or] anything that describes or uses the word 'Medicaid,'' said Dr. Adam Brown, a Washington, D.C.-based emergency physician and founder of a health care strategy firm. 'People oftentimes do not realize either that they have it, or know the value of what it does.' Medicaid is the health insurance program for people with low incomes or certain disabilities. About 72 million people, or about a fifth of all the people living in the United States, are enrolled. It operates with state and federal funding, but every state has the freedom to choose how to run its program, within federal rules. As a result, Medicaid is a sprawling patchwork of programs that can confuse lawmakers and even top health officials, not to mention the average beneficiary. Robert F. Kennedy Jr., now secretary of the U.S. Department of Health and Human Services, incorrectly described basic elements of Medicaid and seemed to confuse it with Medicare during his January confirmation hearing before Congress. Republicans in Congress are considering proposals to slash hundreds of billions of dollars from federal Medicaid funding as they look to offset trillions in tax cuts proposed by President Donald Trump. The specifics of the Medicaid cuts are still being hammered out. But any reductions to federal Medicaid spending would shift those costs to states, which would likely be forced to end services or cut coverage for certain groups of people. 'Part of the problem is when we hear people talk on television or hear lawmakers talk, there are many people that don't make the connection that they themselves are on [Medicaid] or that their hospital is very much dependent upon the dollars that come from Medicaid,' said Brown. Republicans in Congress are eyeing cuts to Medicaid. But what does Medicaid actually do? 'Calling it one thing and branding it something very different, that makes it challenging for people to understand the connection or the value in the product that they actually have.' About 3 in 4 people who have Medicaid are enrolled in managed care organizations (MCOs), according to the latest national data. Most of these are private plans operated by companies such as UnitedHealth Group and Centene. But the branding from these companies can distance recipients from the fact that their care is paid for with public funds. When Brown worked in emergency medicine, he had many patients who had insurance through Medicaid. 'There were times they would show me their card and it would have commercial branding, like a Blue Cross Blue Shield,' he said. But as they talked, 'I noticed there was a lack of understanding that they were on a Medicaid-supported or state/federal-supported program.' Millions of people who are enrolled in Medicaid mistakenly believe they're uninsured, Dr. Ben Sommers, a Harvard health economist and physician, told Stateline. 'It is a long-standing issue that got worse during the pandemic,' he said. He and fellow researchers found that the gap between the number of people who have Medicaid and the number who think they have it jumped during the pandemic, to about 18.5 million people. This was due to a lack of public understanding about a COVID-era rule that granted continuous Medicaid coverage to people without requiring them to re-enroll, researchers found. Sommers expects the gap will eventually return to pre-pandemic levels, or nearly 6 million people. 'That's still a lot of people who don't think they're in Medicaid but who are,' he said. There are also some uninsured people who enroll in Medicaid when they show up at an emergency room or clinic needing care. Most providers will check for Medicaid eligibility if a person doesn't have another form of insurance. People who become Medicaid beneficiaries that way may not realize it's Medicaid paying for their care, Sommers said. Physicians, public health experts and advocates worry that the confusion over Medicaid is affecting public debate over funding cuts. It can be tricky if people don't recognize they have Medicaid and they're trying to weigh in on policies that affect Medicaid. – Ben Sommers, Harvard University health economist and physician From a public health perspective, Sommers said, 'It's not a huge problem if people think they have one type of insurance and misclassify it, as long as they're getting care. 'Politically, it can be tricky if people don't recognize they have Medicaid and they're trying to weigh in on policies that affect Medicaid.' Conservatives have long argued for reducing the reach of Medicaid. They say the program is too expensive and that its expansion under the Affordable Care Act, also known as Obamacare, diverts too much money toward able-bodied adults and away from the more vulnerable populations it was originally intended to help. But despite the controversy surrounding Medicaid, the program is extremely popular. More than 3 in 4 people view Medicaid favorably, including nearly two-thirds of Republicans, according to a January tracking poll from KFF. More than 5M could lose Medicaid coverage if feds impose work requirements In focus groups conducted in January by KFF, no Trump voters and few Harris voters said they were aware of proposals to cut federal Medicaid dollars, and some Trump voters said they didn't think Trump would follow through on the cuts. Brown said that despite confusion, most Medicaid patients he encountered were aware their insurance came through a government program. But he said it can still be hard for people — including those with private insurance — to make the connection between Medicaid funding cuts and their local hospitals or other services. 'We oftentimes frame this [debate over Medicaid funding cuts] as 'People will lose their health insurance,' and that is true,' Brown said. But 'the constituencies affected are not just the people who have Medicaid.' Less funding for Medicaid, or an increase in the number of people without insurance, would harm people with any kind of insurance, he said. It could lead to longer wait times at hospitals, fewer services offered and, in some cases, hospital closures. 'One of the important parts about democracy is people being educated about what their representatives are voting for or against, and also how to advocate for yourself,' Brown said. 'If you don't fundamentally understand or fully grasp the benefits you have, then it's harder to advocate.' Stateline reporter Anna Claire Vollers can be reached at avollers@
Yahoo
02-04-2025
- Health
- Yahoo
Cuts to Medicaid funding will send ‘tidal wave' through Oklahoma's health system
There's been a lot of talk lately in Congress about cutting Medicaid. Known in Oklahoma as SoonerCare and SoonerSelect, Medicaid provides health coverage to low-income Oklahomans, including pregnant women, children, elderly Oklahomans, people with disabilities, veterans and families in need. More than 900,000 Oklahomans — nearly 1 in 4 — depend on Medicaid to access the medical and behavioral health care they need. As an OB-GYN with decades of experience caring for women and families in Oklahoma, I've seen firsthand what these programs have provided for so many families. Medicaid pays for 52% of Oklahoma births and covers 47% of all Oklahoma children. Thanks to Medicaid, I've seen expectant mothers receive access to critical prenatal care and postpartum support they couldn't have afforded otherwise, ensuring better health outcomes for both moms and babies. Medicaid plays a vital role in supporting the health and future of Oklahoma children. Children enrolled in Medicaid miss fewer school days, are more likely to graduate high school and become healthier adults. In a state where nearly half of our children rely on Medicaid, this is a lifeline we can't afford to lose. Every year, Oklahoma receives $7 billion from Medicaid, 68% of the federal funding sent to our state. Think of it as an investment that pays dividends through health care savings and continued reinvestment in the community through salaries, taxes and the purchase of goods and services. Patients on Medicaid who have access to primary and preventative care services are less likely to end up in the ER, where health care costs are far more expensive. Losing even a fraction of Oklahoma's Medicaid funding would create a substantial gap for our state and send a tidal wave through our interconnected health care system. When one part of the system fails, the issue doesn't disappear — the burden is simply shifted elsewhere. More: Proposed Medicaid cuts would be devastating to Oklahoma's most vulnerable | Opinion Cutting Medicaid wouldn't just hurt patients; it could be detrimental to access to care in our state. These funds are a vital lifeline for rural hospitals, many of which are struggling to keep their doors open. Further cuts could strike a fatal blow to these hospitals, negatively affecting not only the health of these communities but also their economy, as many potential employers consider health care resources when expanding into new areas. We can't overlook the hardworking physicians who would take a hit if Medicaid is cut. Many of those who serve a larger number of Medicaid patients — such as pediatricians, OB-GYNS, psychiatrists and family doctors — work on slim margins, and if Medicaid is cut, doctors could be forced to close their practices altogether. The health of our state is worth protecting. Continuing to invest in Medicaid is the best way to ensure Oklahomans receive the care they deserve. Dr. Julie Strebel is an obstetrician-gynecologist in private practice with Mercy Hospital in Oklahoma City. She is president-elect of the Oklahoma State Medical Association. This article originally appeared on Oklahoman: Any cuts to Medicaid would harm Oklahomans, health system | Opinion
