Health coverage expansion still in the waiting room (Capitol Update)

Although nothing is certain until the session ends, it looks like one of the disappointments for this year will be the failure to pass a method for Medicaid expansion. Thousands of people who need medical and mental health treatment will have to wait. Sen. Greg McCortney (R-Ada) and Rep. Marcus McEntire (R-Duncan) worked hard to get something done this session. Sen. McCortney introduced SB 605 which failed to get a hearing before the first deadline. However, work continued, and it appeared for a while that a version of SB 605 could have been brought up in another legislative vehicle that remained alive.

The McCortney/McEntire effort would have adopted something like the Arkansas expansion model using commercial health insurers to administer the program. This seems to be the preferred method in states where political reality requires a circuitous route to implementing the Medicaid portion of the Affordable Care Act. Governor Stitt, however, apparently wants to own this issue and has announced that he has over 100 people working with him from across the state to try to come up with a plan.

There are only so many ways to implement Medicaid expansion. The specific provisions will be in the waiver application to the Centers for Medicare & Medicaid Services (CMS) in an application that will be prepared by the Oklahoma Healthcare Authority. When it’s all said and done, the legislation, if any is required, will likely not look much different than SB 605, only a year later. If the governor has announced his plan by this fall as indicated, the legislation may “authorize” rather than “direct” creation of an Oklahoma Plan, or whatever the governor wants to call it. This will give it the appearance of a gubernatorial rather than a legislative initiative.

This could have been done 7 years ago by following the recommendations of the Leavitt Report commissioned by former Governor Fallin. Kudos to Sen. McCortney and Rep. McEntire for leading on the issue. And kudos to the governor for his efforts. After waiting 7 years, what’s one more year? Well, unless you’re a person with no insurance in need of medical or mental health treatment or a hospital about to go under.


Steve Lewis served as Speaker of the Oklahoma House of Representatives from 1989-1990. He currently practices law in Tulsa and represents clients at the Capitol.

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