- Associated Press - Tuesday, June 24, 2014

Here are excerpts from recent editorials in Oklahoma newspapers:

The Oklahoman, June 23, 2014

Outcry over Medicaid copays is unwarranted

Some Oklahomans on Medicaid could face higher copays next year. Critics are loudly decrying this possibility. Yet we doubt most Oklahomans will lose sleep worrying that a recipient might have to pay $4 for medicine.

The Oklahoma Health Care Authority, which administers Medicaid, faces a shortfall due to federal funding cuts. To help make up the difference, agency officials may raise the copayments that patients pay. Oklahoma Policy Institute, a think tank that promotes increased government spending, believes this is unacceptable. In a release issued last week, the institute declared higher copayments “would shift costs onto the poorest and sickest Oklahomans, make it harder for doctors to effectively treat patients, and cause greater health problems that will mean higher costs later.”

Sounds bad until you notice the actual copays under consideration. Currently, Medicaid patients have no copay for preferred generic drugs. Other copayments range from just 65 cents to $3.50 based on the total cost of the drug. Under the OHCA proposal, those copays could jump all the way . to $4. A Medicaid patient’s copayment for a doctor visit might go from $3 to $4.

OK Policy warns those small sums may be “more than many can afford.” Yet we suspect most Oklahomans, viewing these proposed copayments, have a far different reaction: That’s all?

In 2009, debt.org reports that 73 percent of individuals with insurance coverage through an employer faced a copayment for a doctor visit. The average cost was $21.53.

Keep in mind, those citizens are forking over their hard-earned money for a copayment and at least a share of their premium. That latter expense is one Medicaid patients don’t face. Debt.org reports the average premium costs for a family insurance policy rose 62 percent from 2003 to 2011. The expense jumped from $9,249 per year to $15,022. Although employers covered an average of 74 percent of the cost, the remainder comes out of an employee’s paycheck. Under Obamacare, those expenses are expected to only increase.

Even as they attack these minimal copayments, OK Policy officials argue the state should expand Medicaid. Yet the reason that slightly higher copays are under consideration is because the current Medicaid system is becoming financially unsustainable. That problem won’t be reduced should state officials dramatically expand the program.

It is argued that minimal copayments will cause Medicaid patients to delay treatment, leading to higher costs down the road. That’s debatable. But even if true, why should recipients be exempt from the same concerns that middle-class families face? Money doesn’t grow on trees for most Oklahoma households.

The think tank also cites a study claiming minor co-payments for Medicaid recipients “led to an 88 percent increase in emergency room use.” Left unsaid was the fact that Medicaid coverage, by itself, leads to higher non-emergency use of emergency rooms. A study published in the journal Science found individuals added to Medicaid through an expansion of Oregon’s program made 40 percent more visits to the emergency room than their uninsured counterparts. Most of those visits could have been handled at a doctor’s office.

Contrary to critics’ claims, OHCA’s proposal to boost patient copayments is not evidence of the need to expand the Medicaid program. Instead, it’s evidence of a simple truism: “Free” health care isn’t free.

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Tulsa World, June 23, 2014

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