The Oklahoma Health Care Authority is nearing the end of a nine-month period in which it removed hundreds of thousands of Oklahomans from Medicaid due to the end of federal pandemic health care protections.
The state agency that oversees Oklahoma’s Medicaid program, known as SoonerCare, will complete its Medicaid unwinding process by Dec. 31.
The process requires all states to resume normal Medicaid enrollment and eligibility procedures by ensuring only those residents who qualify are eligible to receive benefits. It comes after the rollback of federal health care protections that were in place for about three years.
During the COVID-19 pandemic, a federal public health emergency prevented states from removing people from their Medicaid rolls even if they were no longer eligible for the health benefits intended for low-income residents. Under normal circumstances, the Health Care Authority regularly disenrolls Medicaid recipients who are no longer eligible due to their income or other reasons.
More than 307,000 Oklahomans had been disenrolled from the health care benefits program by Nov. 30. The agency estimates another 29,769 Oklahomans will be disenrolled in December.
To qualify for Medicaid, an individual must make less than $20,124 annually and a family of four must earn less than $41,400.
About 173,183 Oklahomans lost Medicaid coverage due to procedural denials, in which a person didn’t complete the necessary paperwork to retain their coverage, Health Care Authority spokesperson Emily Long said.
Oklahoma offers real-time Medicaid application processing. If someone discovers they lost coverage, they can reapply and immediately know if they’re still eligible for Medicaid and begin using the health care coverage the same day, Long said.
The Health Care Authority also backdates coverage for 90 days. If someone regains coverage, Medicaid will cover claims going back nearly three months, she said.
The Health Alliance for the Uninsured, which helps people without insurance receive care at more than 90 free clinics across the state, said those facilities are seeing an uptick in patients as more people lose Medicaid coverage.
“We’re seeing an increase in the number of referrals that we’re getting for people needing health care because so many people are losing it,” said Jeanean Yanish Jones, the group’s executive director.
The clinics also are seeing people with more severe health concerns, which can stem from delayed care due to a lack of health insurance, she said.
The Health Care Authority structured its unwinding process to ensure the state’s most vulnerable residents who no longer qualify for Medicaid retained their coverage for as long as possible.
The agency started the unwinding process in May by disenrolling ineligible recipients who did not use their Medicaid benefits, people who already had other health insurance and adults without young children.
As the unwinding process has drawn to a close, the agency began disenrolling Medicaid recipients with chronic conditions, those with young children and those undergoing medical treatments.
“As we get to the end of this nine-month period for the unwinding, we’re at the most vulnerable and the people that are utilizing the services the most,” Yanish Jones said. “This is really a critical part of the unwinding process because the first few months there was a lot less impact because there were people that maybe never even filed a claim. Some people may have not even known they were on SoonerCare”
She said she’s hopeful that as people lose their coverage, they’re taking steps to reapply for Medicaid or acquire health insurance through their employer, the federal marketplace or elsewhere.
It typically takes someone about nine to 12 months to regain health coverage after losing their Medicaid benefits, Yanish Jones said.
Historically, Oklahoma has been among the worst states for its rate of uninsured residents, although the number of uninsured Oklahomans decreased significantly after the state expanded Medicaid in 2021. About 12% of the state’s population, or 463,300 Oklahomans, were uninsured as of last year, according to KFF, a health care policy group.
The Oklahoma Department of Human Services, which oversees Medicaid services for the state’s aged, blind and disabled population, will continue its unwinding process through March.
Oklahoma Voice is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Oklahoma Voice maintains editorial independence.
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