Updated to reflect the OHCA board voted 6-3 to move forward with the managed care contracts.
We have grown accustomed to confrontational government at the federal level. But the degree to which confrontation between the executive and the legislative branches in state government has increased recently is remarkable. There has always been disagreement, and downright wrangling over issues in Oklahoma. For years, legislative sessions have slowed or ground to a halt for days or even weeks while leadership pounded out agreements between the House, Senate, and governor. But confrontation reached a high last session when budget negotiations terminated, legislators passed the state budget in the final weeks of session, and Gov. Kevin Stitt vetoed the budget bill. The legislature overrode the budget veto plus several other measures.
This followed the governor’s having charted his own course in negotiating tribal compacts with the state’s tribal governments, which was his prerogative. But in doing so, he stepped out and unilaterally announced the existing compacts had expired. The tribes disagreed, and unable to convince the governor he was wrong, sued to get a court ruling. While fighting in court with nearly all the tribes, the governor sought to improve his position by entering into compacts with a few small tribes allowing certain games that were illegal under state law. The legislature insisted that making laws controlling state gaming is a legislative function, and gaming laws cannot be changed by inserting provisions in a tribal compact. Failing to reach agreement, legislative leaders sued the governor to get a ruling. The governor lost the cases against both the tribes and the legislature.
At the beginning of the legislative session today, there is every indication the confrontation between the governor and the legislature may continue. Last week the House and Senate Appropriations Subcommittees that handle the Oklahoma Health Care Authority budget held separate budget hearings for the agency. The Senate subcommittee met on Monday, and the House met on Tuesday. The chairmen and members of both subcommittees expressed opposition to the managed care proposal being considered at the direction of the governor. They also complained of lack of legislative collaboration and asked for the opportunity for legislative input before any final decisions were made. Yet on Tuesday at a special meeting, OHCA’s governing board voted 6-3 to allow the agency to move forward with entering into contracts to spend up to $2.2 billion on Medicaid managed care contracts with four private insurance companies. The governor’s five appointees voted in favor while the four legislative appointees opposed. On Friday, OHCA CEO Kevin Corbett announced the contracts had been signed.
The haste with which OHCA acted demonstrates that it was trying to foreclose any legislative action in opposition to managed care. It remains to be seen if that will be successful. It is doubtful the legislature can simply just not fund Medicaid. But there are related issues that will need legislative action to ensure the system can work. I talked to one House leader last week who said, “the House has made its position (against managed care) clear. It just depends on how strongly the members feel.” The governor is part of the legislative process through his veto power. But vetoes can be overridden, as was proven last year. Structurally, the governor is probably in a better position to win this battle. He can act alone while the legislature has to reach consensus. But sometimes people who can act alone overplay their hand. Looking at the record, one might say the governor has been prone to do so.