Is it only a matter of time before Gov. Mary Fallin ends the anti-Obamacare political charade and allows the state to expand its Medicaid program with federal dollars?
Fallin’s current contradiction is glaring. She’s overly concerned with the smoking habits of many of her constituents and says she wants a healthier state, but when it comes to providing them with more access to health insurance she turns into a stubborn ideologue.
That could change now that Florida Gov. Rick Scott, a prominent Republican, has announced his state will expand Medicaid coverage to people with incomes up to 133 percent of the existing poverty line. As Scott put it, “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.”
Scott is just one of seven Republican governors who are now going to join in the expansion despite a recent U.S. Supreme Court ruling on the Affordable Care Act (ACA) that would allow states to opt out of the program.
Under the ACA, the federal government will pay for the entire cost of the Medicaid expansion for the first three years and then the states will contribute a small percentage after that. Fallin has said the added cost in the future—the exact amount is in dispute, but one estimate is only $28 to $37 million annually—is just too much for Oklahoma. Fallin argues it would cost the state an extra $689 million from 2013 to 2022.
The real question, of course, is whether Fallin’s decision was based on political expediency more than personal commitment. All signs indicate she will run for reelection and anything associated with President Barack Obama is politically toxic for Republicans in Oklahoma. On the other hand, Fallin’s recent state of the state address stressed issues that would improve the overall health of the state’s residents, including an effort to reduce the smoking rate here. Is she compensating for her morally unjust decision to deny health insurance to a potential 180,000 low-income Oklahomans?
Let’s be clear: Expanding Medicaid would make a dramatic impact in the state’s overall health outcomes.
Fallin’s plans to reduce smoking rates and increase budget funding for mental health issues are admirable, but they pale in comparison to allowing better access to health care for thousands of people. The legislature has already killed Fallin’s idea to allow cities and towns to ban smoking in public spaces. Now let’s see if the Department of Mental Health and Substance Abuse Services even gets the extra $16 million Fallin proposed in her state of the state speech.
Of course, Oklahoma is no Florida, which gave Obama its majority of votes last November in the presidential election. By accepting the Medicaid expansion, Fallin could give a potential Republican political opponent leverage in the 2014 election.
In addition, the state’s largest newspaper, The Oklahoman, has a fanatical obsession with criticizing so-called Obamacare. A recent editorial fantasized about a doomsday scenario in which new Medicaid recipients couldn’t find a doctor to treat them. Of course, those new people who would qualify for Medicaid probably can’t find a doctor to treat them NOW unless they go to an emergency room.
So what is Fallin to do? The fact the other Republican governors are accepting the expansion absolutely does give Fallin cover to make the courageous decision. Is there any Republican with the same name recognition and overall popularity as Fallin who could seriously challenge her in the gubernatorial primary election in 2014? If she made the decision now to accept the expansion, it would be long forgotten by election season anyway, lost in the state’s collective memory hole. The Oklahoman, now owned by a Colorado billionaire, just doesn’t matter as much anymore within the diversity of the digital media world.
Fallin, 58, might be too young to be overly concerned with her legacy, but her current refusal to accept the Medicaid expansion is a historic error. If she reversed course, she would secure a long-lasting reputation not only as the state’s first female governor but as a compassionate conservative, who made a difficult political decision to provide easier access to health care for thousands of people in a state with a dismal history of poor overall medical rankings.
A couple of Broken Arrow Republican legislators should be reminded that President Barack Obama has been reelected president and the legality of his signature legislation, the Patient Protection and Affordable Care Act, has so far been upheld by the U.S. Supreme Court.
But here in Oklahoma, those basic facts can get into the way of scoring political points in opposing so-called Obamacare with claims that are nothing more than empty and, at this point, extremely tired rhetoric.
State Rep. Mike Ritze has introduced House Bill 1021 that he claims “will nullify the provisions of Obamacare in Oklahoma.” State Sen. Nathan Dahm has introduced Senate Bill 203 as companion legislature. A press release about the bills quotes Dahm this way:
Depriving citizens of the right to make their own choices about health care runs contrary to American ideals. If we want a health care system that is innovative, efficient, and controls costs, we need to allow the free market to work. Health care is not a right, it is an enterprise, and it works best with fewer market distortions and the incentive to improve the services it offers customers. Taking this enterprise and turning it into a government bureaucracy will remove the incentive for advancements in American health care, just as it has everywhere else this experiment has been tried.
How can Obamacare run contrary to American ideals when the president was convincingly reelected? Aren’t American ideals often expressed and shaped through voting? I also wonder how many physicians would agree with Dahm that “health care is not a right, it is an enterprise . . . “ It’s dehumanizing to reduce the purpose of medical treatment solely to the profit motive. Is it just all about “business” when a child becomes extremely sick and needs medical treatment? If the child’s parents don’t have the money for medical care, then what? Health care IS a basic human right that embodies our shared humanity.
HB 1021, which contains the initial language of the legislation, claims that the Affordable Care Act is not “authorized by the Constitution of the United States and violate its true meaning and intent as given by the founders and ratifiers.” Of course, there are a lot of laws, policies and government programs that were not specifically mentioned in the U.S. Constitution. The lack of specificity was exactly the point.
The bill also refers, of course, to the Tenth Amendment, which concerns states’ rights, and is often twisted by extremists on the right to mean that states can pretty much do what they want without any federal interference. Each state, under their thinking, is basically its own country.
Perhaps, the weirdest parts of the bill are the provisions meting out punishments for anyone who practices Obamacare in Oklahoma. Here are those provisions:
Any official, agent, or employee of the United States government or any employee of a corporation providing services to the United States government that enforces or attempts to enforce an act, order, law, statute, rule or regulation of the government of the United States in violation of this act shall be guilty of a felony and upon conviction shall be punished by a fine not exceeding Five Thousand Dollars ($5,000.00), or a term of imprisonment not exceeding five (5) years, or both.
Any public officer or employee of the State of Oklahoma that enforces or attempts to enforce an act, order, law, statute, rule, or regulation of the government of the United States in violation of this act shall be guilty of a misdemeanor punishable by imprisonment in the county jail not exceeding two (2) years, or by a fine not exceeding One Thousand Dollars ($1,000.00), or both such fine and imprisonment.
So we’re going to actually imprison people here in Oklahoma that follow federal rules about basic health care? Why didn’t Ritze and Dahm just throw in Medicare and Medicaid as well?
The bill is another kooky, frivolous attempt to make yet another statement against the president and Obamacare, upheld by the nation’s highest court last year.
Oklahoma’s bordering neighbors Arkansas and Missouri are planning to expand their Medicaid programs under new guidelines in the Affordable Care Act, making sure thousands more of their residents have health insurance.
It makes Gov. Mary Fallin’s decision to NOT expand Medicaid coverage here seem even more outrageous, and it means Oklahoma taxpayers will be funding health care and, by extension, a better quality of life, in neighboring states as we remain one of the unhealthiest places in the nation.
Under the ACA, states can expand Medicaid coverage to people below 133 percent of the poverty line. The federal government will pay for the entire expansion for three years, and then eventually will pay 90 percent of the cost. States were given the option to participate in the program or not in a recent ruling on the ACA by the U.S. Supreme Court, and Fallin and other Republican leaders chose not to do so, citing costs.
It is estimated that Fallin’s decision could leave approximately 180,000 Oklahomans without health insurance coverage. Overall, different estimates show some 600,000 to 700,000 Oklahomans don’t have health insurance, which leads to higher premiums and medical costs for everyone.
In rejecting the expansion, Fallin, a Republican, said it could end up “costing the state of Oklahoma up to $475 million between now and 2020,” but that number was called “greatly exaggerated and misleading” by the Oklahoma Policy Institute, a state think tank widely respected for its budgetary and financial calculations. It’s widely assumed among progressives that Fallin’s decision was based on partisan politics and the irrational and exaggerated GOP rhetoric here surrounding so-called Obamacare.
Compare Fallin’s approach to that of the governors of Arkansas and Missouri.
Arkansas Gov. Mike Beebe said this about the expansion: “I'm for it. I think it's good for our people because it's helping folks that don't have insurance now that are working their tails off. They're not sitting on a couch somewhere asking for something.”
Missouri Gov. Jay Nixon said this about it: “We're not going to let politics get in the way of doing the best thing for our state.”
Both Beebe and Nixon are Democrats, but their states are considered conservative. Republican presidential nominee Mitt Romney won a majority of votes in Missouri and Arkansas in the recent election.
According to Wonkblog, 17 states have now decided to expand Medicaid, 9, including Oklahoma, have chosen not to do so, and the rest haven’t decided yet.
Let’s hope Fallin reverses course and truly considers overall health concerns in Oklahoma, which is consistently ranked as one of the unhealthiest states to live in the country. The high number of uninsured here is a major part of the problem. If Arkansas and Missouri can do the right thing, then surely so can Oklahoma.