What if they’re homeless?

Those are pretty good questions, which the rule doesn’t address but which advocates for Medicaid patients insist must be considered.

“In short, basing ... eligibility for hundreds of thousands of members on their ability to receive a single piece of mail ignores the realities of life in poverty,” Oklahoma Policy Institute Executive Director David Blatt wrote to the Health Care Authority.

In the best-case scenario, eligible Medicaid patients will be forced to re-enroll in the program after they realize they have been disqualified, Blatt says. A more likely scenario, however, is that Medicaid-eligible patients will accept the removal and join the ranks of the uninsured.

They’ll end up in emergency rooms when they’re sick, slowing the ability of hospitals to treat anyone. Insured patients and hospitals will end up absorbing the costs that could have been avoided with proper Medicaid management.

The big losers here will be those least able to speak up for themselves.