Fallin sticking by opposition to Medicaid expansion in Oklahoma
BY WAYNE GREENE World Senior Writer
Friday, February 22, 2013
2/22/13 at 8:33 AM
This story originally incorrectly described the number of states that have accepted or are leaning toward accepting Medicaid expansion. The story has been corrected.
Read the Tulsa World continuing coverage of the health care law.
With Florida Gov. Rick Scott's Wednesday announcement that he is ready to accept "Obamacare" money to expand his state's Medicaid program for at least three years, nearly half the states - representing more than 55 percent of the nation's population - have either opted into the plan or are leaning that way.
A spokesman for Gov. Mary Fallin said Scott's decision that Florida couldn't afford to stay out of the Medicaid expansion doesn't change her stance that Oklahoma can't afford to get into it.
"Governor Fallin has made her decision based on what is best for Oklahoma," spokesman Alex Weintz said. "She does not plan on revisiting the issue."
Scott's announcement makes Florida the 25th state apparently headed toward accepting Medicaid expansion, a key element of the Affordable Care Act's scheme for reducing the number of uninsured Americans.
Seven of the nation's 10 largest states by population have now opted in, and in the past month, states led by ardent Republican opponents of so-called "Obamacare" - Arizona, Ohio and Florida - have joined the list.
"While the federal government is committed to paying 100 percent of the costs, I cannot deny Floridians who need access to health care," Scott said in a press conference Wednesday. "Our options are either having Floridians pay to fund this program in other states while denying health care to our citizens or using federal funding to help some of the poorest in the state."
Costs set to rise
The map of states in and out of the Medicaid expansion closely parallels the 2012 electoral college map. Of the 10 states most clearly not opting into the expansion, none voted for President Barack Obama.
Washington, D.C., and the 14 states that are more clearly headed toward Medicaid expansion were all won by Obama in the November election.
That logic would suggest that four other Obama states led by Republican governors - Pennsylvania, New Jersey, Maine and Virginia - could be primed for tipping.
Under the Affordable Care Act, anyone in a household earning up to 133 percent of the federal poverty level - currently $31,322 a year for a family of four - qualifies for Medicaid coverage starting in 2014, if their state opts to be part of the expansion.
The federal government would pick up 100 percent of the costs of new benefits for the first three years. After that a share of the costs would shift to the states, capping at 10 percent in 2020.
Currently in Oklahoma, only members of specific groups - children, pregnant women, the aged, blind and disabled - can qualify for the federal health care program.
Fallin's decision not to accept the Medicaid expansion money means about 180,000 poor, uninsured Oklahomans won't receive health coverage, but Oklahomans will still pay taxes to fund the program nationally.
Fallin has repeatedly made the point that the federal government would pick up the cost of new benefits but would not pick up additional administrative costs or 100 percent of the benefit costs for people who are already eligible for Medicaid.
A January study by the Kaiser Commission on Medicaid and the Uninsured shows that if there were no Affordable Care Act, Oklahoma's Medicaid costs would rise $24 billion for 2013-22. That cost increases $689 million if the state accepts Medicaid expansion, but it increases by $332 million if the state doesn't accept Medicaid expansion.
Fallin "continues to pursue Oklahoma options for improving health and wellness in the state," Weintz said. "Additionally, she continues to ask the White House to grant states flexibility to expand state-based programs like Insure Oklahoma."
U.S. Health and Human Services Secretary Kathleen Sebelius held a telephone press conference Thursday to roll out $250 million in grants to six states to test new models to drive down Medicaid costs and improve care. Sebelius also announced $35 million in grants to 19 states to develop similar plans.
There is room within "Obamacare" for state innovation, Sebelius said.
"As a nation we know that rising health care costs are putting a growing burden on our families, our business owners and government budgets," Sebelius said. "States have long been innovators and leaders in promoting these kinds of improvements through the Medicaid programs."
She highlighted a $42 million grant to Arkansas to test patient-centered care which will mean that by 2016 a majority of the state's residents will have access to comprehensive team-based care.
Cindy Mann, director of the Center for Medicaid and CHIP Services, said Medicaid programs are rapidly evolving.
"There is ample opportunity in the Medicaid program for new ways to deliver and pay for care, and ... exciting innovations are already under way in states across the nation."
Greta Stewart, executive director of the Oklahoma Primary Care Association, said the state's poorest residents need health care coverage.
"I think Oklahoma will miss a tremendous opportunity to serve its residents, if it does not choose to expand Medicaid," Stewart said. "First and foremost, every Oklahoman deserves access to basic health care."
Stewart said wellness efforts to improve health outcomes for the state - a particular focus for Fallin - are important, but so is financing the cost of health care for sick Oklahomans.
"We are about to cut off the noses of our residents to spite their faces in the name of politics," Stewart said.
Original Print Headline: Fallin sticking by stance on Medicaid expansion
Wayne Greene 918-581-8308
Gov. Mary Fallin: Despite more states' acceptance of Medicaid expansion, Fallin says she has no plans to revisit the issue.