March12,2014
ThePatientsFirstCoalition,whichrepresentsallofthestate’smajormedicalassociations,isverystrongly
opposedtolegislation(HB2788/SB1495)thatwouldprivatizethestate’sMedicaidsystem.





Atnopointhaveanyofourmemberorganizationsbeeninvolvedwiththeworkinggroupsupposedly
discussingthisissue.Webelieveitisfundamentallywrongtomakesuchadrasticchangethatwill
impactmillionsofOklahomanswhenthephysicianswhowillbeaskedtobeartheweightofthis
changeandstillprovidequalityhealthcarehaveneverbeensomuchasconsulted.
TheOklahomaHealthCareAuthorityisoneofthemostefficientagenciesinthestatewithan
administrativeoverheadfarlowerthananyfor‐profitinsurer.OutsourcingtheMedicaidsystemwill
onlybringhigheroverheadcoststhatwillhavebemadeupbyproducingproviderreimbursement.
OHCAisoneofthestate’sfastestpayers,oftenturningcleanclaimsaroundinlessthantendays.For
manysolepractitionersandsmallgroups,Medicaid’srelativelylowpaymentsareoffsetbythe
certaintyofpayment.Withtheadditionalredtapeanddelaysinherentindealingwithprivate
insurers,manyMedicaidproviderswillsimplydecideit’snotworththehassleandwillstopseeing
Medicaidpatients.
WehaveseriousconcernsaboutthefutureoftheSupplementalHospitalOffsetPaymentProgram
(SHOPP)ifthesemeasuresareimplemented.Implementingaprivately‐runmanagedcaremodel
couldputmanyruralhospitalsandotherprovidersinjeopardy.
OtherstatesthathaveprivatizedtheirMedicaidsystemshaveeithernotseenthecostsavingsthey
werepromisedorrepresentanapples‐to‐orangescomparisonthatwillnottranslatetoOklahoma.
Thestatetriedthismodelinthe1990sanditwasacatastrophicfailure.Whilemuchhaschangedinhealth
careinthelast20years,thefundamentalflawsthatcausedthissystemtofailthenarestillinplaceandwill
causethesystemtofailonceagain.Assuch,weremainstronglyopposedtoanyefforttooutsourcethe
Medicaidprogramtolargeinsurerswhocareaboutstockholders,notpatients.
WeurgeyoutovotenoonHB2788andSB1495.
Sincerely,
GabrielPitman,DO ErvinYen,MD
Co‐Chair,PatientsFirstCoalition
Co‐Chair,PatientsFirstCoalition
ThePatientsFirstCoalitionrepresentstheOklahomaStateMedicalAssociation;OklahomaOsteopathic
Association;AmericanCollegeofPhysicians,OklahomaChapter;AmericanAcademyofFamilyPhysicians,
OklahomaChapter;AmericanCollegeofObstetriciansandGynecologists,OklahomaChapter;Oklahoma
PsychiatricPhysiciansAssociation;OklahomaAcademyofOtolaryngology‐Head&NeckSurgery;Oklahoma
SocietyofAnesthesiologistsandtheOklahomaAcademyofOphthalmology.Ourmissionistoensurepatient
safetyandaccesstoqualitymedicalcareforallOklahomans.