Health-Care Access, Medicaid Expansion Among Key Issues in Oklahoma Gubernatorial Race (RH Reality Check)

By Teddy Wilson

On November 4, Oklahoma residents will make a choice for governor between incumbent Republican Gov. Mary Fallin and Democratic nominee Rep. Joe Dorman (Rush Springs).

Fallin has focused her campaign on her record as governor, including her legislative achievements and economic improvements in the state. (Since she took office, the unemployment rate in the state has fallen from 6.6 percent to 4.6 percent.)

Dorman’s campaign messaging has also centered on economic issues—in his case, issues such as rising income inequality in the state. According to a study by the Economic Policy Institute, from 2009 to 2011 the income of the top 1 percent of earners in the state grew by 13.8 percent, compared to 6.5 percent for the bottom 99 percent of earners. Dorman has also focused on state issues such as the lack of storm shelters at public schools. Gov. Fallin has opposed Dorman’s proposal to finance the construction of new storm shelters.

Dorman has framed his opponent as someone who after serving two terms in Congress brought Washington, D.C.’s partisan politics back to Oklahoma City.

Dorman told RH Reality Check that Fallin’s administration has placed more emphasis on the needs of corporations than on the needs of citizens in the state. Fallin’s record as governor includes signing a bill banning cities in the state from raising the minimum wage, implementing a “sun tax” on alternative energy, and a proposal to eliminate hundreds of millions of dollars in tax deductions. This year Fallin proposed cutting the state’s highest income tax rate by 0.25 percent and reducing state agencies’ budgets by 5 percent to pay for that tax cut.

“We see many Oklahomans struggling to make ends meet,” he said. “We need a governor that won’t forget people all across the state, and not just focus on those people who are writing the larger campaign donations.”

(Fallin did not respond to two interview requests from RH Reality Check.)

The Affordable Care Act and Medicaid Expansion

Both candidates originally opposed the Affordable Care Act (ACA).

While representing Oklahoma in the U.S. House, Fallin voted against the health-care legislation. In 2011, after being elected Oklahoma’s governor, she released a statement on the ACA’s one-year anniversary saying that she supported efforts to “repeal and replace” the law.

Dorman has characterized the ACA as “a mess.” In 2010, he voted in favor of placing a state constitutional amendment on the ballot banning the implementation of the individual mandate provision of the ACA in Oklahoma. However, Dorman says that since the Supreme Court has ruled that the ACA is constitutional, lawmakers must work to implement the law. “We have to find a way to make sure that the law fits the needs of Oklahomans,” said Dorman.

Fallin was one of several Republican governors who’s refused federal funds to expand Medicaid as part of the ACA. According to a 2012 Oklahoma Health Care Authority report, the state could save $48 million a year by expanding Medicaid.

The state does have a system in place to provide health-care access to low-income residents. Implemented in 2005, Insure Oklahoma uses state and matching federal funds to provide employer-sponsored insurance to low-income residents who are employed. The number of low-income residents the program covers has decreased, from 30,033 in May 2013 to 18,776 in May 2014, largely due to the fact that residents making between 100 and 200 percent of the federal poverty level now qualify for subsidized insurance on the Affordable Care Act marketplace.

Insure Oklahoma was scheduled to expire at the end of this year but was recently extended through the end of 2015. The federal Centers for Medicare and Medicaid Services allowed the extension to negotiate a path to expand Medicaid that would include incorporating Insure Oklahoma into the expansion. According to the agency, there is no deadline for when a state must decide whether to expand Medicaid, and a number of states are continuing to consider their options.

In a press release following the announcement, Dorman said that the extension is a “Band-Aid” compared to expanding Medicaid in the state. “If we accepted Medicaid expansion, it would cover nearly eight times as many Oklahomans. It is ridiculous for Fallin to reject such a valuable program that would do everything Insure Oklahoma does and more.”

Dorman says that as governor he would keep the Insure Oklahoma program, and work to expand Medicaid benefits.

“We have so many working poor that are [in the coverage gap], that simply cannot afford insurance,” said Dorman. Last year 6,900 low-income residents who became ineligible for Insure Oklahoma were also unable to qualify for subsidized health insurance under the ACA. According to the Kaiser Family Foundation, there are a total of 144,480 low-income uninsured and non-elderly Oklahomans in the coverage gap.

We have to do what we can to provide insurance for them,” said Dorman.

Hospitals in Oklahoma have already been faced with a difficult financial situation; operators of the Mercy health system blame the lack of Medicaid expansion for having to lay off 300 workers.

Last week a White House report found that the failure of 24 states to expand Medicaid has had serious consequences for uninsured residents in those states. The report found that if Medicaid expansion was enacted in Oklahoma, an additional 123,000 low-income residents would receive health-care coverage.

Reproductive Rights

On issues of reproductive rights, the candidates do not differ substantively; both Fallin and Dorman have staunchly anti-choice voting records.

Similar to many states in the region with Republican-controlled state legislatures, during the 2013-14 Oklahoma legislative session several bills were introduced to restrict reproductive rights, and six eventually became law. As a result of this legislation, two of the state’s three abortion clinics will likely be forced to close. The staff of what will likely be the state’s lone abortion clinic worries it will be the target of even more anti-choice legislation, and reproductive rights advocates fear that this lack of access to safe, legal abortion care will lead to women seeking out illegal and possibly unsafe abortions or attempting to self-induce abortion.

Fallin’s campaign website promotes her record of signing anti-abortion legislation in the state, including legislation that banned abortion after 20 weeks’ gestation, banned private insurance coverage of abortion, and restricted the use of medication abortion.

Fallin also had a consistently anti-choice voting record while in Congress.

Dorman does not mention his position on reproductive rights anywhere on his campaign website, but in more than a decade in the state house, Dorman has consistently voted for anti-choice legislation. In an interview with the Spanish language newspaper La Semana, he said that his views on anti-abortion restrictions are in line with the values of his constituents.

Dorman told RH Reality Check that he identifies as “pro-life” and is opposed to abortion. “But I do feel that we need to create better programs for Oklahomans that would allow for more adoptions, provide better prenatal care, and provide for more opportunities for the women to carry the child to birth,” he said.

“I think that the government of Oklahoma, and across the United States, has not done enough to take care of women’s health and provide opportunities to allow women to have the chance to carry their child. Many feel that they have no opportunities, no hope,” he said.

Dorman added that he does not think it is realistic to eliminate abortion. “Going back to the laws that we had pre-Roe v. Wade, it creates an unsafe condition for women,” he said. “We have to do better. We have to come up with policies that still allow women to have choices when it comes to health care.”

Dorman told RH Reality Check that he does not see any inconsistency in supporting access to health care for low-income Oklahomans while at the same time supporting restricting access to reproductive health care. “Not at all,” he said.

Since Fallin was elected governor in 2010, Dorman has largely supported the anti-abortion bills she has signed into law. During that last legislative session alone, Fallin signed laws requiring abortion providers to obtain admitting privileges at a local hospital, restricting the use of medication abortion, and amending the state’s informed consent law to creating additional reporting requirements for providers.


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