Oklahoma has told CMS it won't move forward with its plan to institute a block grant program for Medicaid.
In a brief letter dated Aug. 11, Oklahoma's state Medicaid director Melody Anthony thanked CMS for its efforts and said the state "looks forward to further opportunities to work together on state initiatives."
SoonerCare 2.0 would have allowed Oklahoma to impose premiums and work requirements on Medicaid expansion enrollees while accepting a limit on how many federal dollars the state would receive. Patient groups opposed the plan.
But Oklahomans ultimately voted for a straight Medicaid expansion in June, thwarting Republican Gov. Kevin Stitt's block grant plans.
Oklahoma has the second-highest uninsured rate in the country behind Texas. The Oklahoma Health Care Authority projected that more than 200,000 new Medicaid enrollees may sign up due to the ballot initiative's passage, for a total annual cost of about $1.3 billion. The estimated state share would be about $164 million. But those numbers could be considerably higher given the number of Oklahomans who have lost their jobs and work-related health insurance because of the economic downturn during the coronavirus pandemic.
Before the ballot initiative, Stitt also sought CMS approval for waivers to convert the state's Medicaid program into a capped federal funding model under the Trump administration's newly announced Healthy Adult Opportunity program. He wanted to shift beneficiaries into private Medicaid managed care plans.
CMS made block grant demonstrations available to states beginning in January, hoping the savings could benefit state and federal coffers. But states didn't have strong incentives to apply for a Healthy Adult Opportunity waiver because they would take on more financial risk for the expanded population without receiving much additional flexibility. Most of the flexibility afforded to states under the plan is already available under Medicaid Section 1115 waivers, including the ability to institute a work requirement, adjust cost-sharing or eliminate retroactive coverage.