December 16, 2014

State Wins Affordable Care Act Grant

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The Obama administration announced Tuesday it had chosen Oklahoma to receive a grant of up to $2 million to develop innovative models for delivering health care.

The award is significant because it represents a rare departure from the state’s general reluctance to participate in programs authorized by the Affordable Care Act, sometimes characterized as Obamacare.

Oklahoma is one of 28 states chosen to receive funding in the second round of the State Innovation Models grant program. The grants total $665 million nationwide.

“If we are going to move Oklahoma forward, we know we have to improve health outcomes in the state,” Alex Weintz, communications director for Gov. Mary Fallin, said in an emailed statement. “Whether it’s infant mortality, obesity, or high rates of smoking, we need to use our existing resources more effectively.”

Weintz said the grant would help lay the groundwork for better services without increasing state costs. “It is not about expanding the size or scope of government, but making the services we already offer better and more efficient,” he said.

In previous interviews, Fallin’s office and the State Department of Health said they applied for the grant because they considered it to be a worthy exception to the elements of the Affordable Care Act they don’t support. Those include the development of a state-run health insurance marketplace and expansion of Oklahoma’s Medicaid program, known as SoonerCare.

David Blatt, executive director of the non-government Oklahoma Policy Institute, said he was pleased to hear that the state would receive a grant under the Affordable Care Act.

“This is one important opportunity created by the ACA for the state to pursue innovative health care reforms,” Blatt said. “However, as long as we stubbornly refuse to accept federal funds to expand insurance coverage for our poorest citizens, we will still run into insurmountable barriers in making Oklahoma a healthy state.”

The State Innovation Models program is designed help states develop new ways to reduce costs and improve services for participants in Medicaid, Medicare and the Children’s Health Insurance Program.

“We are committed to partnering with Oklahoma to advance the goals we all share: better care, smarter spending, and, ultimately, healthier people,” U.S. Health and Human Services Secretary Sylvia Mathews Burwell said in a prepared statement.

When Fallin applied for the federal grant in July, she said the state intended to develop an Oklahoma State Innovation Model based on “health system innovation that makes good business sense.”

The grant application targeted four pervasive health problems: obesity, diabetes, hypertension and tobacco use. It noted that Oklahoma had high rates of deaths caused by heart disease, stroke, cancer and diabetes.

Fallin said in the application she had assembled a team from the public and private sectors to participate. Led by the Health Department, they include four other state agencies, two large employers, four health insurers, three hospital systems, three academic medical centers, six medical associations, four Native American tribes and the State Chamber of Oklahoma.

The governor’s decision to seek the grant was notable because the Affordable Care Act has met with widespread opposition in Oklahoma and because she chose in the past to avoid participating in some of its biggest components.

In 2011, Fallin decided to reject a $54 million grant that would have helped Oklahoma develop its own state-based insurance marketplace for people interested in purchasing individual health plans. In 2012, Fallin turned down an opportunity to expand its Medicaid program so more poor people would qualify for benefits.

The state decided to make an exception earlier this year when the Health Department signed up as a partner in an application for another grant program called Health Care Innovation Awards. It was not among those accepted by the Obama administration.

The State Innovation Models program represents another foray by the state into limited participation in Affordable Care Act, which was passed by Congress and signed into law by President Obama in 2010.