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Okla. Releases Application for Medicaid Block Grants

Oklahoma made public its March 16 application for a “Healthy Adult Opportunity” (HAO) Section 1115 demonstration waiver.

Under an HAO waiver, states are granted more flexibility to provide Medicaid coverage by agreeing to implement an optional block grant (aggregate cap) or per-capita cap on federal matching funds. The Centers for Medicare & Medicaid Services outlined the new HAO initiative in a Jan. 30 State Medicaid Director letter.

Oklahoma is pursuing the per-capita cap option under the HAO initiative. If approved, the waiver would only apply to the Affordable Care Act Medicaid expansion population. Oklahoma submitted a March 6 state plan amendment to expand Medicaid eligibility up to 133 percent of the federal poverty level, effective July 1.

In addition, the waiver would:

  • establish premiums, cost-sharing, and copay requirements;
  • incorporate work and community engagement requirements as a condition of eligibility; and
  • eliminate retroactive eligibility and hospital presumptive eligibility.

Oklahoma will seek approval for a five-year demonstration, to begin on or after July 1, 2021. The waiver application is open for a 30-day public comment period, which ends April 15.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Zina Gontscharow is a former senior policy analyst for America's Essential Hospitals.

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