OKPOLICY.ORG
By Simon Maloy
(Credit: Reuters/Carlos Barria)
If one were to forced to choose which state has demonstrated the most political hostility towards the Affordable Care Act, you could definitely build a strong case for Oklahoma. The state is about a red as it gets – Obama lost Oklahoma to Mitt Romney by 34 points in 2012. Its attorney general sued the government over Obamacare’s individual mandate, and he won praise from conservative leaders for pursuing some exotic (and unsuccessful) legal actions against the law. The state legislature has voted several times to (unconstitutionally) nullify the Affordable Care Act. Oklahoma’s senior senator believes that Obamacare, if it had been given the chance, would have killed him.
At the same time, you could also build a strong case that few states are in more dire need of Obamacare’s help than Oklahoma. Owing to the intense political opposition, Oklahoma refused to set up its own healthcare exchange and refused to expand Medicaid under the Affordable Care Act. At the time the law passed, Oklahoma’s uninsured rate was 21.9 percent, the sixth highest in the nation. By 2014, the rate had dipped to 18.5 percent, but was still among the highest in the country. (Neighboring Arkansas, which cooperated with the ACA implementation, saw its uninsured rate cut in half.) Per the Kaiser Family Foundation, Oklahoma’s refusal to expand Medicaid left 23 percent of its uninsured population (roughly 144,000 people) trapped in the so-called coverage gap.
So there’s tension between a state population that could obviously benefit from healthcare reform and a political establishment that opposes said reform on ideological grounds. That tension, however, appears to be breaking as state Republicans are looking to sign up for expanded Medicaid.
As the AP reports, the immediate impetus behind the abrupt reversal of state-led opposition is “a huge $1.3 billion hole in the budget that threatens to do widespread damage to the state’s health care system.” The state’s budgetary crisis is partly due to oil conditions, and partly due to zealous adherence to conservative tax policy. Oklahoma relies heavily on the oil and gas industries, but the plummeting price of oil on the global market meant that the state’s tax revenues from those industries also took a nosedive. Compounding the problem is the fact that the state has spent more than a decade passing tax cut after tax cut, depriving the state government of revenue and forcing steep cuts to social programs. As the Oklahoma Policy Institutenotes, the state’s Medicaid agency has already absorbed huge cuts over the past few years.
Per the AP’s reporting, the situation has become so critical that the state healthcare system is in imminent danger of collapse and can’t absorb any more reductions in funding:
