Families USA’s State Comment Letter on Oklahoma’s Per Capita Cap 1115 Waiver

Families USA submitted this letter in response to Oklahoma’s request for comments on its proposed section 1115 waiver to institute a per capita cap that limits federal funding for the state’s Medicaid program. Oklahoma’s waiver proposal follows recent guidance from the Centers for Medicare & Medicaid Services that allows states to fundamentally alter their Medicaid program by instituting block grants and per capita caps. Additionally, Oklahoma is proposing a work reporting requirement, new premiums and copayments, benefit cuts, and the elimination of retroactive and presumptive eligibility for beneficiaries.

This proposed 1115 waiver includes multiple elements that are both legally problematic and poor policy choices for the state, especially during the current COVID-19 public health crisis. Instead of pursuing this waiver to limit coverage, Families USA recommends that the state dedicate its staff time and resources to expanding its Medicaid program and ensuring everyone in the state can access testing and treatment.