Fallin rejects health care exchange, Medicaid expansion
BY WAYNE GREENE World Senior Writer
Monday, November 19, 2012
11/19/12 at 4:21 PM
Gov. Mary Fallin on Monday rejected state participation in a health care exchange and expansion of the state’s Medicaid program under the Affordable Care Act.
The decision means Oklahoma will not do anything to accommodate the controversial federal health care law — known as “Obamacare” — but it also means the state will skip an opportunity to help some 693,000 uninsured Oklahomans, 18.7 percent of the state population, get coverage through the federal government.
“After careful consideration, I have today informed U.S. Secretary of Health Kathleen Sebelius that Oklahoma will not pursue the creation of its own health insurance exchange,” Fallin said. “Furthermore, I have also decided that Oklahoma will not be participating in the Obama Administration’s proposed expansion of Medicaid.”
Any exchange that is compliant with the federal health care law will necessarily be state-run in name only and would require Oklahoma resources, staff and tax dollars to implement, Fallin said.
“It does not benefit Oklahoma taxpayers to actively support and fund a new government program that will ultimately be under the control of the federal government, that is opposed by a clear majority of Oklahomans and that will further the implementation of a law that threatens to erode both the quality of American health care and the fiscal stability of the nation,” she said.
A Medicaid expansion would cost the state up to $475 million between now and 2020, with escalating annual expenses in subsequent years, Fallin said.
Other estimates of Medicaid expansion are much lower, and some show the state would actually save money with the move.
“In reality, the expansion is a very favorable deal for Oklahoma,” said David Blatt, director of the Oklahoma Policy Institute.
The federal government will pay 100 percent of the cost for the first three years and then gradually shift costs to the states with a that amount capping at 10 percent in 2020. The Oklahoma Health Care Authority estimates the state’s share of Medicaid costs in 2020 would be $28 million to $37 million, an amount that is less than 0.5 percent of current state appropriations, Blatt said.
With savings to the state’s health, mental health and prison programs and increased tax revenues from new medical professionals needed to cover increased demand that would come with the expansion, the Urban Institute has estimated that Oklahoma’s budget comes out saving money with the move.
But Fallin said the Medicaid expansion is the wrong direction for the state.
“It would also further Oklahoma’s reliance on federal money that may or may not be available in the future given the dire fiscal problems facing the federal government,” Fallin said. “On a state level, massive new costs associated with Medicaid expansion would require cuts to important government priorities such as education and public safety.”
The proposed Medicaid expansion offers no meaningful reform to a massive entitlement program already contributing to the out-of-control spending of the federal government, Fallin said.
Fallin said the decision was made after working with legislators, stakeholders and health care experts from around the country.
Fallin said the state will pursue Attorney General Scott Pruitt’s legal challenge of the federal health law and will “pursue state-based solutions that improve health outcomes and contain costs for Oklahoma families,” Fallin said.
“Serious reform, for instance, should be pursued in the area of Medicaid and public health, where effective chronic disease prevention and management programs could address the trend of skyrocketing medical bills linked to avoidable hospital and emergency room visits,” she said. “I look forward to working with legislative leaders and lawmakers in both parties to pursue Oklahoma health care solutions for Oklahoma families.”
Legislative leaders backed Fallin’s decision.
“Oklahomans simply do not want anything to do with Obamacare, and Senate Republicans stand firmly with Governor Fallin in rejecting it,” said Senate President Pro Tem Brian Bingman, R-Sapulpa. “We want real, conservative solutions to the rising cost of health care — we want to make care more accessible, more affordable and easier to obtain.
“I continue to believe Obamacare will fall short of accomplishing these goals — but it will certainly accomplish one of President Obama’s goals: to grow government and redefine its size, scope, and reach into the lives of our fellow Oklahomans.”
Speaker of the House-elect T.W. Shannon, R-Lawton, applauded Fallin’s decision.
“It is increasingly evident that reform will come from the state level,” Shannon said.
“Oklahoma has drawn a line in the sand, and I am proud to stand with Gov. Fallin and our citizens to continue leading the fight against a federal government that increasingly overreaches and tramples the rights of individuals and the states.”
But Democratic lawmakers said they will look for ways to force the issues to a vote in next year’s Legislature and will place the blame for the state’s failure to move ahead in health care coverage on the governor.
“On behalf of the hundreds of thousands of uninsured Oklahomans and the businesses, doctors and hospitals who provide for millions of dollars worth of uncompensated care, the House Democratic caucus is deeply disappointed,” said Rep. Scott Inman, D-Oklahoma City.
He said the governor was playing politics with the health and finances of poor Oklahomans, which he finds frustrating.
Gov. Mary Fallin speaks at the Tulsa Convention Center in July. MATT BARNARD/Tulsa World file