Apr. 8—An Oklahoma state lawmaker introduced legislation Wednesday to stop Gov. Kevin Stitt from overhauling Oklahoma’s Medicaid program.

Rep. Marcus McEntire introduced legislation for the Oklahoma Health Care Authority to implement internal managed care as opposed to outsourcing care management for most Medicaid recipients to four major insurance companies.

In other words, McEntire, R-Duncan, wants to reform the Health Care Authority so the agency better manages health care for Medicaid recipients in-house.

McEntire has been an outspoken critic of the governor’s $2 billion plan to implement privatized Medicaid managed care, in which the state would pay private companies to oversee health care for most of the program’s beneficiaries. The changes, which were approved by the Health Care Authority board, are expected to occur in the fall, after Oklahoma expands Medicaid on July 1 to cover more low-income residents.

“Our members have been lobbied on this so hard and talked to by health professionals in our districts,” he said. “We need to show them that we stand with them so we can be on the record in our stance on managed care.”

In a statement, Stitt doubled down on his privatized managed care proposal, dubbed SoonerSelect.

The plan is designed to improve Oklahoma’s health outcomes, he said.

“It is irresponsible to use hundreds of millions of taxpayer dollars to require a state agency to create a program that already exists and is successfully implemented in 40 other states,” Stitt said.

McEntire’s Senate Bill 131, which was amended Wednesday to address managed care, is essentially a political Hail Mary. He said he’s confident the bill can pass the House, but the legislation faces a rockier path in the state Senate, where the chamber’s floor leader supports the governor’s Medicaid plan.

Even if McEntire can get his bill to the governor’s desk, he’ll need two-thirds majorities in both chambers to override a likely veto from Stitt.

“He’s going to veto it,” McEntire told the House Public Health Committee. “There’s no doubt in my mind.”

Nevertheless, the House panel advanced SB 131 on a 9-1 vote.

Proponents of SoonerSelect say private health insurance companies are better equipped to oversee care for hundreds of thousands of Oklahomans, and can offer incentives the state cannot. Critics, however, have expressed concerns that much of the taxpayer funds used to pay the insurance companies would go out-of-state, even though the companies would be required to have a presence in Oklahoma.

While SB 131 doesn’t expressly prohibit privatized managed care, McEntire said continuing with SoonerSelect would violate the “legislative intent” of the bill if it becomes law.

A chief complaint from some state lawmakers is that they haven’t had a say in the governor’s decision to outsource Medicaid care. Stitt and the Health Care Authority solicited bids and inked contracts with health insurance companies while Oklahoma’s Legislature was out of session.

An in-house managed care model would be cheaper and give the Legislature more oversight of the program, McEntire said. The bill language he unveiled Wednesday is similar to the SoonerCare 2.0 plan the Legislature funded last year — legislation Stitt ultimately vetoed.

In a statement, Health Care Authority spokeswoman Melissa Richey said McEntire’s bill would require “significant financial investment,” but didn’t specify how the agency calculated the costs.

“We estimate those costs to exceed $200M each year for the foreseeable future,” she said. “Further, SB 131 would significantly delay our ability to connect Oklahomans with the quality health care they deserve. We agree with the importance of care management and investing in primary and preventive care, and we are confident we can accomplish these goals with our current SoonerSelect partners.”

McEntire said he wouldn’t be surprised if the state gets sued for breaking the managed care contracts with the health insurance giants, but said that shouldn’t stop lawmakers from doing what they believe is right. If SB 131 becomes law, the contracts would become null and void, he said.

Privatized managed care is an approach to health insurance coverage that seeks to maximize health care quality while cutting costs.

Managed care companies are like health care middlemen that drive down costs, which provides more budget consistency for states. If the companies succeed in driving down costs, they profit from the state’s payments.

A coalition of health care groups sued the Health Care Authority, questioning the agency’s authority to shift to a Medicaid managed-care model. The lawsuit has yet to be heard before the Oklahoma Supreme Court.