Sen. Tom Coburn
A measure of how important Tom Coburn is in the Oklahoma Republican Party is that both side of the GOP schism over House Bill 2130 are claiming to represent his thinking.
And, in a way, both are right, but the far right is righter.
HB 2130 has seriously divided the Republicans: Gov. Mary Fallin, Speaker of the House Kris Steele and Senate President Pro Tem Brian Bingman are working for the bill, which would establish a state-run health insurance exchange. The most conservative Republicans in the Legislature and the Tulsa County Republican Party see it as the first step toward Obamacare, especially because the state is using up to $54 million in federal grant money to pay for the program.
During last week’s House debate on the measure (it passed with one more vote than a majority and with 19 Republicans voting against it), both sides were making reference to what Coburn would do.
Usually, federal elected officials don’t want to get too involved in state Legislature debates, so I was pleasantly surprised when one of the senator’s press aides gave me a details response to a request for clarification on Coburn’s position. Randy Krehbiel got a little bit of her statement in his
good storyabout the debate today, but it was such a good statement I want to give it a fuller airing.
Both sides in the debate can find some comfort in the answer I got from Becky Bernhardt, Coburn’s deputy press secretary.
First, Coburn supports the concept of health insurance exchanges, which are essentially government efforts to organize the health insurance marketplace for consumers so they can compare prices and coverage and make purchases simply.
“Dr. Coburn supports state-based efforts to create free-market voluntary health insurance exchanges that encourage transparency, consumer choice, and individual control,” Bernhardt said. “States should be able to use state dollars to pursue innovative strategies to better equip consumers with information about their health coverage choices.
“In this model, consumers can compare plans via the Internet or a toll-free number, so they can choose a plan tailored to their individual needs. In this way, state-based exchanges can help facilitate the purchase of private health insurance based on price and quality.”
Specifically, Coburn prefers a model such as has been designed by the state of Utah – the so-called market-based solution – as opposed to the Massachusetts model, which is heavily regulated, bureaucratized, mandates, and tied to the ideas of the federal health care law.
“The main problem with health insurance is that it costs too much - but the changes in Massachusetts and Obamacare have been proven to simply increase the cost of coverage, while failing to improve access,” Bernhardt said.
I don’t think any of that gives Fallin, Steele or Bingman any heartburn. In fact, it’s pretty much what they say, but the next part of Bernhardt’s statement would.
“Dr. Coburn supports states using state dollars to tackle the challenges of their own population,” she said. “He does not think that any state involved in a lawsuit against Obamacare should use administration grant dollars to set up an exchange -- regardless of whether that exchange looks more like Utah's model or Obamacare's model.”
Oklahoma is suing the to have the federal law declared unconstitutional (with Coburn’s support) and it has taken that $54 million grant. So, the conservatives in the Legislature are right: Coburn doesn’t support the direction Oklahoma is headed with the health insurance exchange insofar as it is federally funded.
They have no problem with the concept of a health insurance exchange, they just don't want is links to the federal government or paid for it that way -- in other words, the full Coburn.
Fallin has argued that without HB 2130 is a bulwark against Obamacare: The state will have a federally designed health care exchange imposed on it if the lawsuits against the federal law’s constitutionality aren’t successful. One thing’s clear: No one in this argument – Fallin, Steele, Bingman, any of the GOP legislators and certainly not Corburn – wants that.
