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Bill would divert alcohol tax revenues to health care centers

By Steve Metzer

The Journal Record

OKLAHOMA CITY – Using the words “dumpster fire” to describe the state of health care in Oklahoma, members of a Senate subcommittee voted on Wednesday to advance a bill aimed at shoring up funding for federally qualified health centers.

Passage of House Bill 1132 would create a fund to help health centers cover costs of providing “uncompensated” care for people who don’t have insurance. State Sen. Casey Murdock, a Republican from tiny Felt in Cimarron County, spoke on behalf of the bill. He said the measure proposes tapping 5% of tax revenues generated by the sale of alcoholic beverages in the state to keep clinics, especially in rural areas, out of critical condition.

“Health care centers in my district in rural Oklahoma have been struggling,” Murdock said. “We’ve already lost a center in my county and one in the next county over is struggling.”

In other parts of Oklahoma, Murdock said health centers, described as outpatient facilities that qualify for special reimbursements under Medicare and Medicaid, will “dive after a dime if one falls out of your pocket.”

Murdock said the title had been removed from HB 1132, as details are still being worked out as to how money collected in a special revolving fund would be administered by the state Health Department. He said it’s anticipated that 5% of tax revenue generated through sales of alcoholic beverages would amount to about $2.6 million in Fiscal Year 2020. Details to be worked out include how the money would be divided equitably among clinics in rural and urban areas and what would happen to any money not needed by clinics to recover costs of providing uncompensated care.

State Sen. Rob Standridge, R-Norman, expressed concerns about federally qualified health centers leveraging financial advantages they already have over competitors to “run competitors out of business.” Murdock responded that he wasn’t aware of that happening in more urban areas but that health centers he knows about in rural counties are in trouble.

Community health centers are local, nonprofit providers that must serve designated medically underserved areas, accept all payer sources and offer a sliding fee scale for lower-income patients, including those who don’t have health insurance, the senator said. They serve more than 230,000 Oklahomans, including more than 70,000 who are uninsured.

In October of 2017 the state Department of Health reported that it could no longer afford to absorb costs of $1.6 million in uncompensated basic health care, dental care, mental health and substance abuse treatment provided to Oklahomans by community health centers.

“Health centers put health care where it is needed,” Murdock said, “(They have) been shown to reduce overall health care expenditures and are an economic support for many parts of our state.”

State Sen. Greg McCortney, R-Ada, said he knows that FQHCs do great work providing care even when they’re not compensated, but he said much more needs to be done to solve Oklahoma’s bigger health care problems.

“I just think this dumpster fire is a whole lot bigger than what can be solved by a few million dollars here and there,” he said. “I think we need to think a whole lot bigger than what we are here.”

Murdock responded that he felt passage of the bill could be an important first step in addressing the overall problem.

“I don’t want to be the guy watching it burn,” he said. “I want to take steps to fix it.”

State Sen. John Haste, R-Broken Arrow, also expressed reservations but offered that by passing the bill without title it would give lawmakers a chance to work out details to potentially solve an important piece of the larger problem. The Health and Human Services subcommittee “does legwork” for the Senate Appropriations Committee. For the bill to advance for a vote by the entire Senate, it still would have to pass in the Appropriations Committee.

“(Passing the bill with its title removed) gives us the opportunity to continue our conversation,” Haste said. “There are major issues here and we need to have a conversation and accomplish something.”

At the conclusion of the discussion, the Senate subcommittee members opted to advance the bill on an 8-2 vote.

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