OK-SAFE Response to Federal Health Care Reform committee

OK-SAFE, Inc.

AP reporter Sean Murphy on Tuesday asked OK-SAFE Executive Director Amanda Teegarden for some comments about the 2011 Joint Legislative Committee and Health Care Reform Law. (Teegarden spoke to this committee on 11/3/11 in Tulsa.)

Formed at the conclusion of the last legislative session to examine the impact of the federal health care reform law on Oklahoma, this committee held its’ fifth (and final) meeting on Tuesday, 11/15/11 in the House chambers.

Video of the meetings is posted on the OK House website.

Below are the five questions asked and OK-SAFE’s responses.*

Q. 1 )   Do you think the Oklahoma Legislature should ignore the federal requirement that a health care exchange be established? If so, why?  

• Yes, we think the Oklahoma Legislature should ignore the federal requirements for an exchange.
•  While we can appreciate the complexity of the health care issue in general, we believe that the main problem with this committee’s efforts was the fact that health care reform was not defined to begin with.  Health care reform is actually about the development of the IT (information technology) framework that establishes a Nationwide Health Information Network, the creation of an electronic health record on everyone, the flow of highly personal information across jurisdictions, and government access to everyone’s health and medical records.
• Several presenters actually spoke about this Nationwide Health Information Network as a “federal data hub” – one presenter referred to what the feds are doing as being like “something out of a TV show.”
• What this “hub” does is allow the federal government access to any and all information a state may have on it’s citizens, including their health and medical records.
• The state of Oklahoma is progressively developing the infrastructure necessary to help facilitate this federal data hub, sometimes referred to a “globally integrated and networked intelligence enterprise”.

Q. 2)   What about the provision that provides if a state doesn’t establish an exchange, the feds will do it for them?

• The state of Oklahoma has been establishing “health care reform” for a while now, and in 2010 established a public-beneficiary public trust called the Oklahoma Health Information Exchange Trust (OHIET).  (SB 1373 in 2010).
• This trust is establishing the ‘network of networks’ that allow for the seamless flow of electronic health records (including medical records) throughout the state, and elsewhere.
• The OHIET’s purpose is to establish the framework for health information exchange , to establish a ‘network of networks’ and to link providers, payers and patients.
• According the OHIET’s Cooperative Agreement with the Office of the National Coordinator (the feds), the OHIET plans to align the state’s health information exchange(s) with the federal requirements.
• Because the OHIET trust has been actively implementing the technological infrastructure necessary for “ObamaCare” to function in this state, it doesn’t matter if the state establishes a state-based health insurance exchange or lets the federal government establish it for us.  The functionality of a state-based insurance exchange will be the same as the federal governments exchange and it will be linked to the health information exchanges.

The OHIET HIE logic model. Do we really want this system in Oklahoma? Do we want to make it easier for the feds to access our health records?

Q. 3)   Do you think the state should count on the health care law being overturned/dismantled by a the Supreme Court or a future administration?

• Because of the OHIETs activities and other agencies’ activities, it won’t really matter if the Court finds the individual mandate unconstitutional. The technological framework establishing the two exchanges – the health information and the health insurance exchange – and linking to the Nationwide Health Information Network, is moving forward.
• The only differences allowed in a state-based insurance exchange would be those differences that don’t make a difference.  For instance, the state has some flexibility in defining who the Navigators will be and the role they’ll play, and whether the exchange website portal functions like Expedia or not.
• All of the technological standards, interoperability and information sharing requirements, as well as government and third party access to records, will be aligned with the federal governments requirements.

Q. 4)   What are your thoughts about the ability of the tea party and other grassroots conservative groups like yours to successfully fight against the establishment of the exchanges and to resist the implementation of the federal health care law in Oklahoma?

• While we’re not speaking for all the grassroots groups in Oklahoma, we think the state should not establish a health insurance exchange. It’s contrary to what the people of Oklahoma want, and we already voted against it  (at least, we thought we did).
• Politically, it would be better to let the feds take all the blame for what is going to happen.  Any legislator who decides to move forward with an exchange – whether a state-based non-profit, a for-profit, or a hybrid – is going to be forever linked to it.
• Next year is an election year – it is my understanding that the citizens of Oklahoma will be making an issue of the health insurance exchanges.

Q. 5)   What are your thoughts in general about this task force and the work they’ve conducted, recommendations they should make?

• In general, the committee chairs leaned toward speakers that favored the establishment of a state-based insurance exchange and who advocated for following the requirements of ARRA and PPACA.  Other than two speakers from OCPA, OK-SAFE was about the only other “conservative” organization featured.
• OK-SAFE Recommendations: Don’t build a state-based exchange in any format.  Allow providers, payers and patient an escape route – they should not have to play (or pay) into this “network of networks”; let them function outside any and all exchanges without penalty.
• Further recommendation:  Terminate the OHIET trust and audit the OHCA.

*It is not known when, or if, these responses will used by the AP reporter, who sent his request on 11/15/11.

In the meantime, write your legislator and tell them we still mean NO to “Obamacare” – and this includes the exchanges.

[Go to http://www.oklegislature.gov, click on Legislators to see contact information.]