Medicaid expansion gets no traction in state Legislature (NewsOK)

By Rick Green

One of the strategic objectives on the state’s new “performance transparency website” calls for sharply decreasing the number of Oklahomans without health insurance.


The state could go a long way toward achieving this objective by expanding Oklahoma’s Medicaid system under the federal Affordable Care Act. This would provide health coverage to more than 100,000 low-income people who now lack insurance.

But any discussion of participating in the act, also known as Obamacare, remains politically toxic for Republican state officials.

Gov. Mary Fallin has often railed against Obamacare, GOP legislative leaders want nothing to do with it and state Attorney General Scott Pruitt has a lawsuit against subsidies provided under the act to at least 55,000 Oklahomans.

Alex Weintz, the governor’s spokesman, said the state can’t afford such an expansion, even though the federal government would pay most of the costs and a state-commissioned study indicated a net financial benefit to the state.

Some Republican-controlled states like Indiana and Arkansas have found a way to take federal funds under the act to boost health care coverage, but that remains a non-starter here.

“It is not something we’re pursuing,” Weintz said. “We don’t think the state can take on the additional costs required.”

Health coverage important

Still, the importance of bringing health coverage to more Oklahomans is highlighted on the new website,, a so-called “dashboard” intended to allow policymakers and the public to track state agencies’ progress toward achieving five statewide goals, involving 50 statewide programs and 160 strategic objectives.

Currently, 17 percent of Oklahomans lack health insurance. The objective calls for reducing this to 9.5 percent by 2019.

“Fewer uninsured people in the state can benefit the overall health system by reducing the level of spending on uncompensated care and reduce the number of people who avoid treatments for financial reasons,” the website explains.

David Blatt, director of the Oklahoma Policy Institute, said Medicaid expansion should be obvious.

“Expanding coverage to unhealthy low-income adults would be the biggest thing we can do to drive down untreated mental illness, obesity, diabetes,” he said. “This is the only path.”

A state-commissioned study known as the Leavitt report found that, although the federal government would cover most of the expansion, the direct cost to Oklahoma would be about $850 million over 10 years. But the report indicated the net impact would be a savings to the state of $464 million when taxable income associated with the additional spending was taken into consideration.

Medicaid expenses

Weintz said the state is having difficulty covering existing Medicaid expenses for about 800,000 people, without covering another 100,000 people.

“The governor continues to say it’s not fiscally prudent to expand a program that we are currently having a hard time paying for,” he said.

Blatt takes issue with this stance since the Leavitt report indicated a net savings for the state.

“It’s the equivalent of saying I can’t take a job because it’s going to cost me additional money in gas, clothing and childcare, without considering I’d also make a salary,” he said. “They look at the expenditure side only, so that’s not a look at a full or fair picture.”

House Speaker Jeff Hickman, R-Dacoma, and Senate President Pro Tem Brian Bingman, R-Sapulpa, have taken stands against Obamacare.

Bolster rural hospitals

House Minority Leader Scott Inman, D-Del City, said federal financial support for expanded Medicaid would return to Oklahoma the money state residents pay in federal income tax and would bolster struggling rural hospitals.

“Other Republican governors are bringing their federal dollars home to take care of their citizens but this governor says, no, we’re not going to accept any of our federal dollars, instead we’re just going to wag our finger and tell folks they need to eat better and smoke less.”

As for the goal on the state’s new dashboard website, the explanation for how the number of uninsured Oklahomans can be drastically reduced between now and 2019 is less than specific:

“Strategies to achieve this goal include increasing outreach to those eligible for Medicaid or low-cost health insurance, and developing strategies to expand affordable insurance programs in the state.”


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