Health-care forum panelists weigh in on benefits, political unlikelihood of expanding Medicaid in Oklahoma (Tulsa World)

By Mike Averill

Panelists at a health-care forum Wednesday discussed reasons the state should accept federal dollars to expand Medicaid, particularly through the Insure Oklahoma program, and the unlikelihood of that happening.

Expansion would provide insurance to more than 100,000 uninsured Oklahomans who fall in the “coverage crater,” said David Blatt, executive director of the Oklahoma Policy Institute.

“They are ineligible for Medicaid as it exists in the state now because they earn too much … but they are also ineligible for the tax credits that would allow them to purchase affordable health coverage,” said Blatt, one of four participants in the Tulsa Regional Chamber-sponsored forum.

To close the gap, he pointed to Insure Oklahoma, a state-grown program that uses Medicaid funding and money from the state tobacco tax to provide insurance to more than 17,000 people who do not have access to group coverage and who earn less than the federal poverty level. It also insures people who are temporarily unemployed and seeking work.

The program, however, is capped in terms of enrollment and has limited eligibility.

Blatt argued that if the state were to expand Insure Oklahoma, the federal government would cover all the costs through 2016 before scaling down to 90 percent of the costs by 2020.

“Governor (Mary) Fallin and political leaders say we need an Oklahoma plan. Well, expanding Insure Oklahoma is an Oklahoma plan,” he said, adding that the expansion would help relieve pressure on cash-strapped state budgets.

By accepting federal funds under the Affordable Care Act, or “Obamacare,” between from 2016 to 2023, the state would take in about $9.9 billion.

That funding would have a $17.9 billion impact in total new revenue for the state while creating nearly 24,000 jobs and increasing state and local tax revenue by $620 million, said Lynn White, director of government relations and political action for the Oklahoma Hospital Association.

“Do we really have a big recruitment opportunity that brings in this type of money that I’ve missed?” White said.

Rep. Doug Cox, a chair on the Oklahoma House appropriations and budget committee on health, said that Medicaid expansion, even using the popular Insure Oklahoma as a foundation, is unlikely.

“The most common question I’m asked is if the governor is going to change her mind to Medicaid and I would say ‘I doubt it,’” Cox said.

“And more importantly, even if she did, the political will in the Legislature is not there to support that decision.”

A major reason for that lack of political will is the unpopularity of President Barack Obama in the state and the harsh reality that, even though some projections show the positive financial impacts of Medicaid expansion, the immediate need of balancing budgets doesn’t allow for increasing expenditures in hopes of savings down the road.

“Every legislator has their own set of values, and health care is not at the top of the list for everyone,” Cox said.

In addition to the political realities of risking other programs to shift money to health care, Medicaid is a program that still has a stigma attached to it, Cox said.

“It’s still seen as a 100 percent entitlement program,” he said, adding that 59 percent of those who would benefit from the expansion of Medicaid are working.

“It’s hard to overcome that stigma that people on Medicaid are lazy folks that can work but don’t.”

Blatt said that expanding Medicaid is the only way to meet the governor’s stated goal of cutting Oklahoma’s uninsured rate nearly in half by 2019.

“The Affordable Care Act is here to stay,” Blatt said.

“It’s time Oklahomans stop fighting this reality and instead look at the enormous opportunity this law creates to help the hard-working families of this state.

“Oklahoma’s tax dollars aren’t paying for expanded coverage in Oklahoma, but they are paying for expansion in Arkansas, Kentucky, Oregon and 27 other states with expanded coverage,” Blatt added.

“Let’s bring those dollars back home.”


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