We'll pay for Medicaid expansion anyway
BY WAYNE GREENE World Senior Writer
Sunday, December 30, 2012
12/30/12 at 6:42 AM
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Rep. Doug Cox understands the medical needs of the working poor better than most Oklahomans.
Cox, R-Grove, is an emergency room doctor in an impoverished part of rural Oklahoma. So, he quite literally spends his working hours binding the bleeding wounds of the people directly impacted by Gov. Mary Fallin's decision not to accept federal money to fund an expansion of Medicaid in Oklahoma.
"I see it every day," Cox told me Friday from his hospital's emergency room. "Contrary to popular belief, these are not deadbeats. These are usually hard-working people in low-paying jobs for companies that don't offer health insurance."
He described one patient who has been driven to the emergency room a couple of times to deal with the pain of a bum gall bladder.
She has a job, but it doesn't offer insurance.
She can't afford surgery and now faces the prospect of losing her job because of the work time she has lost.
"She's one of the people who would be covered if we expand Medicaid," Cox said.
Unlike Fallin, Cox says the state can't afford not to accept the Medicaid expansion proposal. The federal government will cover 100 percent of the new benefit costs for three years, and the state can back out of the offer at any time after that, if it can't afford to continue the coverage.
The Oklahoma Health Care Authority estimates that 155,000 Oklahomans fall under the medical cliff. They don't earn enough money to qualify for federally subsidized private health insurance from an exchange starting in 2014, and they aren't categorically qualified for Medicaid.
"I'm kind of the black sheep of the Republican Party," Cox said. "I guess I'm saying we need to take this thing."
Chief Justice John Roberts' decision that found the Affordable Care Act constitutional also makes it clear that Medicaid participation by the states is optional, Cox said.
"I say, 'What have we got to lose by signing up to help these people get access to medical care,' " Cox said. "If we find on down the road that indeed we cannot afford it, then we drop out."
Otherwise, Oklahomans get to pay for Medicaid expansion in other states, but don't get any of the benefits of it, he said.
"So, we're going to have all these indigent people to take care of and ... we're still going to pay the fines, pay the penalties and pay the increased taxes, and all our money is going to take care of people in other states," he said.
Really, really red: What's black and white and red all over?
A zebra that doesn't know how to use lipstick.
What's just plain red all over?
The Oklahoma State Capitol.
You'd need a search warrant to find a Democrat there.
The governor is a Republican.
All the secondary officeholders are, too.
Seventy-five percent of the state Senate and 72 percent of the House are in the GOP, too.
In the 2012 presidential election, for the second presidential election in a row, every Oklahoma county voted for the Republican candidate.
Oklahoma could claim to be the reddest state in the union, but the title isn't undisputed.
Red: Republicans control the governor's office and both legislative bodies in 25 states.
Redder: In 16 states, including Oklahoma, the Republican legislative majorities were big enough in both houses to override any governor's veto.
Reddest? The difference maker must be the state's congressional delegation, especially the two crimson stalwarts that stand in its forefront - the one-two punch of U.S. Sen. Jim Inhofe (National Journal's Most Conservative Member of the U.S. Senate in 2010) and U.S. Sen. Tom Coburn (the 2011 winner).
In a sort of one-upsmanship for conservative credibility, the two are willing to take even an extreme position to an extreme.
In blizzards, droughts and hurricanes, Inhofe can be counted on to maintain steadfastly that man-made climate change is not just debatable but an absolute hoax.
And while the Newtown, Conn., massacre is still fresh enough in memory to lead NRA members in Congress to talk about gun control, ABC political reporter Chris Good offers that Coburn could be the one senator willing to take an Alamo stand against the idea.
"The last time Congress considered a major gun law - one with broad support - Coburn held it up, proving that the details of gun control are sticky when a conservative senator raises unpopular objections, especially a senator who's joked that it's too bad he can't carry a gun on the Senate floor," Good wrote last week.
Rep. Carolyn McCarthy, D-N.Y., a longtime gun-control advocate whose husband was killed in a mass shooting on the Long Island Rail Road in 1996, introduced a widely supported bill to do just that. The NRA backed her National Instant Check System Improvement Amendments Act of 2007.
But Coburn didn't. The senator blocked action on the bill, citing concerns over patient privacy, limited gun access for veterans, and the cost of updating the background-check system,
In blocking that bill, Coburn pointed to a government study noting that 140,000 veterans had been referred to the background-check registry since 1998 without their knowledge.
Coburn succeeded in changing the legislation, negotiating a set of tweaks that shaved $100 million over five years, made it easier for prohibited gun owners to restore their gun rights, and notified veterans that if they abdicated control of their finances they would be added to the gun database. The bill passed, and President George W. Bush signed it in January 2008.
Rhyme time: In another life, I spent my Friday afternoons writing political limericks online.
A friendly reader suggested that the end of the year might be a good time to dip a toe back into that water. While I don't plan to make it a habit, I will offer this ditty:
We're reaching the fiscal cliff.
It seems like a when, not an if.
The spin docs' manure
will appear haute couture
until it is given a good sniff.
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Original Print Headline: State will pay for Medicaid expansion anyway
Wayne Greene 918-581-8308
wayne.greene@tulsaworld.com
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