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State program provides health insurance

OKLAHOMA CITY (AP) _ Pam Harris has a lot of responsibility, but a state program has lifted one major concern for the master teacher at Storytime Child Care.

She has been able to get health insurance through a program in which the state, the employer and the employee share the cost of coverage. Employers with 25 employees or fewer are eligible to enroll in the program, but certain income limitations apply.

``It removes a big worry off my shoulders, especially when you have kids to care for and you go home and care for some more kids,'' said Harris, the mother of three.

During the Oklahoma legislative session that begins Feb. 6, Gov. Brad Henry will seek to expand the program, which took effect Nov. 1, to include employers with up to 50 workers. He bills it as a public-private partnership to help working Oklahomans.

Harris and husband James, director of Storytime Child Care, had no health insurance coverage until the program took effect.

``I think it is fantastic. There was no way I could have afforded insurance before,'' James Harris said. He said four other full-time workers will be covered by the program, bringing stability to the center's small work force.

``I lose a lot of employees because they want medical insurance.''

Coy Ivey, owner of Coy's Wrecker Service in Edmond, said he and his two wrecker drivers now have coverage thanks to the program.

``I don't want my employees to go without health insurance,'' said Ivey, a CPA who also runs as a one-man tax service business. ``Employees without health insurance are not happy and you want your people to be happy.''

Henry hopes the program will grow and eventually ease rising insurance rates.

The governor pushed through a tobacco tax increase to help pay for the program and it was overwhelmingly approved by voters.

Officials said a key reason for the spike in health insurance rates is that medical costs of people who do not have coverage are passed on to people who are insured. About 20 percent of Oklahomans do not have insurance.

The Legislature devoted $50 million to tackle the problem in the first year. Those funds were used to produce $100 million in matching federal dollars.

Oklahomans with salaries up to 185 percent of the federal poverty level are eligible, the same criteria for Medicaid patients. Employers pay 25 percent of the premium cost and employees pay 15 percent or a maximum of 3 percent of their monthly income.

Nico Gomez, spokesman for the Oklahoma Health Care Authority, said about 150 small businesses had signed up by mid-January and interest is growing.

``It's been a good success story so far for small businesses,'' said Paul Sund, spokesman for Henry. ``This gives them a helping hand. We think the more businesses that sign up the better it will be for Oklahoma because it reduces the number of uninsured.''

Henry says he will be back this session with a drug reimportation program after having to settle for legislation last year that amounts to enlisting the support of the drug industry in seeking discounts for medications.

Although the pharmaceutical industry opposes reimportation, Henry said soaring prescription drug costs are the No. 1 driver of high medical expenses and ``the status quo is simply unacceptable.''

Some Republicans opposed Henry's plan, saying it is impractical. Rep. Dan Sullivan, R-Tulsa, said it amounted to ``a false promise.''

Funding of Medicaid will be another big issue for the legislative session.

Last year, hospitals supported an increase in patient fees to raise federal Medicaid funds, but that proposal was blocked by House Speaker Todd Hiett. Instead, Hiett agreed to using $63 million in surplus natural gas revenue to beef up Medicaid funding.

House Democrats say a permanent funding source is needed to ensure the state gets all available Medicaid funds.

Hiett appointed a task force to look for $100 million in waste in the state Medicaid program, with the idea of using those funds to replace the gas revenue.

But after a series of meetings at the Capitol and around the state, the task force was unable to find cost savings of that magnitude.

Gomez said he expects Medicaid reform to be a topic of debate at the state and federal level for years to come, partly because of outdated federal policies.

``The stress on the system is typically from working adults ages 19 to 64 who are not disabled but do not make enough money to buy health insurance or choose not to buy insurance. Medicaid historically does not cover that situation.''

Rep. Kris Steele, chairman of the House Medicaid task force, has proposed a system whereby Medicaid recipients would get more choices based on their needs.

Among other things, the plan would permit Medicaid participants to opt out of the program and use their state-allocated Medicaid ``premium'' to join an employer-sponsored health care plan.

Lawmakers warn the Medicaid system could cripple the state budget in future years, especially if federal support dwindles.

The system has a $3.36 billion budget this year, with about 70 percent of the funding supplied by the federal government.
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