State needs to embrace ACA, health care execs say (Journal Record)

By Kirby Lee Davis

TULSA – The U.S. Supreme Court’s King v. Burwell ruling leaves Oklahoma little choice but to embrace the Affordable Care Act, several health care executives told a Tulsa Regional Chamber audience Wednesday.

But such views ignore political realities, said physician and state Rep. Doug Cox, chairman of the state House Appropriations and Budget Committee on Health.

“The political will in the Legislature is not there to support that decision,” said Cox, R-Grove.

The high court’s 6-3 ruling last month removed the ACA’s last major legal challenge that should rise under President Barack Obama’s term, said Conner & Winters attorney and partner Teresa Burkett.

“The ACA is here to stay,” said David Blatt, executive director of the Oklahoma Policy Institute. “It’s time for Oklahoma to stop fighting this reality and instead look at the enormous opportunity this creates.”

The Oklahoma Hospital Association is developing a plan for its members to fund state expenses in setting up and operating an ACA exchange, said Lynne White, OHA director of government relations and political action. She said some rural hospitals may not survive much longer without such support, due to the much higher proportion of uninsured patients they receive.

“The state’s failure to expand coverage means too many Oklahomans, including insured patients, are losing sources for care,” Blatt said.

Under its Transforming Health Care project, White said the association has put together a proposal and database demonstrating cost savings Oklahoma may achieve by expanding Insure Oklahoma, the state’s existing Medicare and Medicaid arm, into an ACA exchange.

By accepting $9.9 billion in federal funds to run an exchange from 2016 through 2023, White said the state would see 23,986 new jobs created in health care or related fields. This would increase state and local taxes by $620 million, according to OHA sources.

“Do we really have a big recruitment opportunity out there that brings in this kind of money that I’ve missed?” she said. “I’d lay that on the table.”

Blatt cited the Leavitt Partners report commissioned by Gov. Mary Fallin, which suggested 12,062 to 15,196 new jobs could be created from embracing federal health care reforms. That promised a total economic impact of $14.2 billion or more.

But the clock is ticking, several panelists warned. ACA provides for 100-percent federal government funding of exchange costs only through 2016. After that the state will pick up a portion of that tab on a graduated scale, peaking at 10 percent in 2020.

“Let’s do it now,” said Burkett. “Let’s do it as quick as we can, because we’re losing money every day that we don’t.”

Cox doubted Fallin or the Legislature would change their opposition to Obamacare. Not one county voted for the president in either election, Cox reminded his audience.

“All politics are local,” Cox said. “I’ve certainly learned that in my 11 years in the Legislature. Most legislators will not buck their constituents.

“My thinking is that access to health care should be a right,” he said. “How you use that access is up to the individual.”

The House veteran also questioned whether many voters would want to give up road construction, Arts Council support, business incentives or other state programs to fund the projected $485 million that an expanded Insure Oklahoma would still cost the state over its first 10 years.

“The harsh reality of it is we have to balance that budget every year,” said Cox. “We can’t bet on something happening and funding it this year.”

Blatt challenged Cox’s cost projection, referring back to Leavitt report findings that the state could actually save up to $485 million in expenditures from new federal funds that would cover some existing corrections, mental health, and health department programs.

Cox warned audience members that ACA supporting moves will face some tough opinions against certain Medicare and Medicaid policies, not to mention entitlement preconceptions.

“From that standpoint I think the expansion of Medicaid per se stands a slim to none chance,” he said. “However, Insure Oklahoma is a popular program. There is support for that. I think the hospital association and their plan does stand a good chance.”

Cox also reminded listeners that President Reagan backed using emergency rooms for the poor’s critical care needs.

“If we can call this new plan the Reagan Memorial Health Care Plan, I can get it to sail through the Legislature,” he said.


Carly Putnam joined OK Policy in 2013. As Policy Director, she supervises policy research and strategy. She previously worked as an OK Policy intern, and she was OK Policy's health care policy analyst through July 2020. She graduated from the University of Tulsa in 2013. As a student, she was a participant in the National Education for Women (N.E.W.) Leadership Institute and interned with Planned Parenthood. Carly is a graduate of the Oklahoma Center for Nonprofits Nonprofit Management Certification; the Oklahoma Developmental Disabilities Council’s Partners in Policymaking; The Mine, a social entrepreneurship fellowship in Tulsa; and Leadership Tulsa Class 62. She currently serves on the boards of Restore Hope Ministries and The Arc of Oklahoma. In her free time, she enjoys reading, cooking, and doing battle with her hundred year-old house.

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