OKPOLICY.ORG
When we elect someone to public office, should we expect them to use their best judgment in making decisions about the public interest? Or should they adhere to the dictates of outside groups that always take the most simplistic and extreme stance on their particular issue, regardless of the context for Oklahomans? And when politicians sign a pledge sponsored by a special interest, should that give the interest veto power over the legislators’ judgment?
A couple of recent events have put these questions into dramatic relief. The first concerns a hospital provider fee, which would be assessed on participating hospitals and matched with federal dollars to pay for treating Medicaid recipients. Hospitals support the fee, since the match would generate another $223 million beyond the $153 million they pay into it, and the combined funds would then return to the hospitals as reimbursements for patient care.
The Senate passed the fee by a large, bipartisan margin. Previously the House voted for it with similarly strong support. The bill was slightly amended in the Senate, so it now heads back to the House. However, a letter by Americans for Tax Reform (ATR), the anti-tax lobbying group headed by Grover Norquist, threatens to throw a wrinkle into the debate.
Norquist said he would score support for the fee as a violation of ATR’s “no new taxes” pledge. Yet even by Norquist’s own logic, his opinion should have no bearing on the issue. This was revealed in the second recent event, an exchange between Norquist and Senator Tom Coburn.
When Coburn expressed support for eliminating ethanol subsidies and using the revenue to pay down the deficit, Norquist said he was breaking the ATR pledge. In response, Coburn asked which is more important, “The pledge to uphold your oath to the Constitution of the United States? Or a pledge from a special interest group who claims to speak for all of American conservatives, when in fact they really don’t?”
Norquist replied that when Coburn signed the pledge, he was making a promise to his constituents, not Americans for Tax Reform. Yet if that’s the case, it shouldn’t be up to Norquist to determine what is and is not a tax.
By their votes, legislators have already made clear that they view the fee as a reasonable strategy for funding Medicaid. It was carefully designed to act as a fee rather than a tax, since increasing taxes is constitutionally restricted in Oklahoma. Rather than being passed on to consumers, it would reduce hospitals’ burden by eliminating cost-shifting to cover inadequate state reimbursements for Medicaid. It would rely on federal money, but even if you believe federal spending needs to decrease, there are plenty of ways to do that without depriving hundreds of thousands of Oklahomans of accessible health care.
And make no mistake, that’s what denying the hospital provider fee would mean. About one in five Oklahomans, or more than 700,000 people, rely on Medicaid for treatment. Without additional funds provided by the fee and match, hospitals would continue to lose money treating Medicaid patients and many could be forced to close their doors. That would put hundreds out of work and eliminate what could be the only nearby health care provider, especially in rural areas.
Only 7 of 48 Oklahoma Senators and 26 out of 101 House members have signed the AFR pledge, though Gov. Fallin and Lt. Gov. Lamp are also signatories. These leaders now have a choice: do they represent Grover Norquist, or do they represent Oklahoma?
When state lawmakers in Oklahoma sign the Taxpayer Protection Pledge they are making a promise to their constituents not to vote to increase taxes – not Grover Norquist, not Americans for Tax Reform, not some special interest.
This issue, as you admit, has been made abundantly clear in the exchanges between ATR and Senator Tom Coburn.
Calling HB 1381, the hospital “provider fee”, a “fee” and not a tax is nothing more than a clever ploy – a rush for political cover. A fee is charged in exchange for a service, it should not contribute to any type of general fund. HB 1381 – which funnels the so called “fee” into the Supplemental Hospital Offset Payment Program Fund (a revolving fund managed by the State Treasury) – is therefore not a “fee”. It is clearly and undeniably a tax.
If the special interests backing the legislation were so confident in the definition of HB 1381 as a “fee” then why were they scrambling to ensure that they secured three-fourths of both houses of the legislature? The Oklahoma state constitution only requires said super-majorities for tax increases, not “fees.” A court challenge would undo HB 1381 without attaining three-fourths of both houses and placement on the ballot for popular approval in the next election.
The problem of HB 1381 being a tax increase could be solved simply enough by ensuring that the bill is attached to an off-setting tax reduction – the legislation would then not be in conflict with the pledge signed by many Oklahoma lawmakers.
Question: Why are we charging this “fee” in the first place? We are charging people to use the hospitals just to turn around and give that money back to the hospital. Why not just let the hospital decide if they want to charge a fee to the consumer and then give the hospitals a tax subsidy for money they spend on Medicare and uninsured patients.
Under my plan, hospitals would control how much they charge consumers. The state/federal government would still pay the money they are planning with this “fee” scheme. Everyone wins.
I really don’t care to whom the pledge is made to, it was written by a special interest group who has their own agenda and who has no interest in what the citizens of Oklahoma might need or want. I don’t recall the citizens of Oklahoma ever clamoring for any of our elected officials to sign “pledges” written by special interest groups. In fact, I think most people, like myself, weren’t even aware of the practice until the dust up with Coburn. Glad to see he’s thumbing his nose at these people and representing his constituents needs.
Dear Okies,
What if Grover is discovered to be a subversive agent of the People’s Republic of China? What if old Grover is simply gaming the system for his own benefit? What if Grover could be buying ultra-shorts on US Bonds like that Canter guy in the House? Political representatives of the people beware! The signing of pledges smells bad! These things should not be taken lightly! They are essentially and practically very, very bad for our democracy.
Regards,
Martin Pitts