Tag Archives: Medicaid

Re-branded, ObamaCare’s Medicaid expansion still wrong for Oklahoma

A top priority for OCPA Impact has been for Oklahoma to hold firm on not implementing the optional expansion of Medicaid prescribed by the Affordable Care Act (“ObamaCare”).

To her credit, Gov. Mary Fallin has maintained Oklahoma will not adopt Medicaid expansion (link).

As pointed out by the Oklahoma Council of Public Affairs (link), Medicaid expansion would cost Oklahoma taxpayers hundreds of millions in additional dollars, as thousands of able-bodied, childless adults with income under 133% of the federal poverty level would be added to this federal entitlement.

Unlike most federal entitlements, Medicaid, while funded in part by the federal government, is primarily administered by state governments.

A recent piece in the Wall Street Journal (link) is a stark reminder that states that have accepted the ACA’s Medicaid expansion to increase enrollments have seen billions of dollars in unanticipated cost overruns.

Now, state government bureaucrats in Oklahoma want to use the current $1.3 billion state government budget shortfall as an excuse to squeeze in a re-branded version of the ACA’s Medicaid expansion (link).

The Oklahoma Health Care Authority, the state’s Medicaid agency, is pushing what it calls its “Medicaid Rebalancing” plan. A proposed 150% tax increase on cigarettes (link), which OCPA Impact opposes (link), is intended to fund the plan.

In a recent Journal Record column (link), OCPA’s Jonathan Small stated that the OHCA’s “Rebalancing” plan is, in fact, ObamaCare’s Medicaid expansion:

“With this attempt, OHCA bureaucrats have tried to box policymakers in by using a set of public relations tactics. First, the OHCA warned the Medicaid program may end. Then, the OHCA declared Medicaid (a taxpayer-funded entitlement program) the largest health insurer in the state. Then, the OHCA warned of cuts to the program, by way of provider cuts of 25 percent. Of course, the media ran with that story, stoking frenzy.”


“Nearly 27 percent of Oklahomans were enrolled in the Medicaid program during the most recent fiscal year according to the OHCA. If they get their way with their plan, then nearly 33 percent of Oklahomans will have their health care paid for nearly in full by government. This wouldn’t even take into account Medicare.

“Without the ACA Medicaid expansion, Oklahoma’s spending on Medicaid has grown largely because of the number of people on the program and previous expansions proffered by OHCA.

“Now, to swindle policymakers into a proposal that will incentivize people to decrease work and drop private health care coverage to gain subsidies, OHCA bureaucrats say their plan should be tried because they will release some currently on the Medicaid program to the treacherous, federally funded Obamacare exchange.


“Expanding government health care or welfare programs is bad policy and short-sighted whether oil is $100 a barrel or $30 a barrel. This is just a planted and dangerous distraction from lawmakers prioritizing spending in a tough budget year and providing the pay raise for teachers that they should by the end of this legislative session.”

Still, serious concerns exist about possible closures for health facilities located outside Oklahoma’s metro areas.

Unfortunately, the response from state bureaucrats has been to propose increasing the number of Oklahomans dependent on government for their health care and increasing our state’s dependency on federal dollars.

The OHCA’s “Rebalancing” plan is not intended to merely maintain Oklahoma’s current Medicaid levels. Rather, it would increase by at least 175,000 the number of Oklahomans enrolled in government-funded health care.

Thankfully, other routes are available. OCPA Impact has already helped successfully promote reforms, proven elsewhere — including in Florida and Louisiana — to reform Medicaid in Oklahoma. The goal should be to bring down the cost curve for taxpayers and increase sustainability without reducing quality of service for people eligible for the program.

OCPA Impact’s 2015 legislative scorecard (link) featured House Bill 1566, which Gov. Fallin signed into law to begin these reforms in Oklahoma. But the OHCA has been slow to implement the measure.

An additional option would be for Oklahoma lawmakers to use a portion of the investment earnings from the Tobacco Settlement Endowment Trust (TSET) to provide stopgap funding for health facilities outside the metro areas that are truly in need in Oklahoma’s current economic climate.

OCPA Impact will continue working to help keep ObamaCare’s costly Medicaid expansion out of Oklahoma.

Results achieved in Oklahoma’s 2015 legislative session

Oklahoma’s 2015 legislative session concluded May 22. At OCPA Impact, we set four objectives prior to the start of session.

These were: (a) enact paycheck protection to safeguard taxpayers from out-of-control government-sector unions, (b) expand options for children to attend schools that best meet their educational needs, (c) advance reforms to reduce the cost curve of state government spending, and (d) continue working to end Oklahoma’s burdensome income tax.

Due to efforts by groups like OCPA Impact and Americans for Prosperity’s Oklahoma chapter – along with growth-minded state lawmakers – results were achieved on these items.

On Apr. 2, Gov. Mary Fallin signed into law House Bill 1749, a paycheck protection measure resembling Wisconsin Gov. Scott Walker’s reforms.

The new law prohibits Oklahoma state government from collecting dues for organizations that collectively bargain against taxpayers at the state agency or school district level. Taxpayers had previously been forced to facilitate dues collections for labor unions that funded extreme political causes.

This session also saw passage of House Bill 1693, updating the Equal Opportunity Education Scholarship, one of two private educational choice programs in Oklahoma.

Established in 2011, the scholarship gives parents access to better educational opportunities for their school-age children. This year’s update makes it easier for students from special populations, including disabled, homeless or abused children, to participate.

Proposals were also promoted to allow parents to utilize another option, Education Savings Accounts (ESAs), to place their children in more suitable educational environments outside the public system. The ESA issue advanced further this year than in 2014 and is alive for next spring’s legislative session.

Passage of House Bill 1566, a significant reform of Oklahoma’s Medicaid system, should help reduce the cost curve of state government spending.

Medicaid has become the fastest-growing area of state spending. Oklahoma’s Medicaid system is fee-for-service, with little emphasis on responsible individual behavior. This has led to cost overruns. The new reform begins a shift to a structure in which care is better coordinated among providers to improve health outcomes for beneficiaries, reducing costs.

There was also progress this session on responsibly ending Oklahoma’s “penalty on work,” the state income tax. With states like Missouri, Kansas and Arkansas reducing tax rates on working families and entrepreneurs, Oklahoma must compete.

Last fall, the Oklahoma Supreme Court upheld the income tax reduction passed by lawmakers earlier in the year. Justices had been expected to throw out – but instead upheld – the reduction, which is still scheduled to lower Oklahoma’s tax rate to 5 percent starting Jan. 1, 2016.

This session, rumblings at the Capitol suggested lawmakers might cancel this tax relief so they could spend more money.

When a left-leaning, New York City pollster said Oklahomans didn’t want a tax reduction next year, numerous opinion surveys by Oklahoma firms were pointed to, debunking this myth.

In the end, lawmakers passed a budget that preserves the upcoming income tax reduction and keeps Oklahoma’s tax rate moving in the right direction – down.

OCPA Impact Supports Medicaid Reform Proposal

OCPA Impact supports passage of House Bill 1566, Medicaid reform, by state Rep. Glen Mulready and state Sen. Kim David.

This measure represents a significant reform of Oklahoma’s Medicaid system. As Oklahoma practices better management of its Medicaid system, the federal funds offered via the Obamacare Medicaid expansion will appear less and less enticing.

Medicaid represents the fastest-growing area of Oklahoma’s state government spending over the past decade. Due to rapid growth in recent years in Oklahoma’s Medicaid spending, total state spending on health care now exceeds total state spending on education.

One of the chief objectives of reforms such as those contained in HB 1566 is to better coordinate care among providers in order to improve the health outcomes of individual Medicaid beneficiaries — individual people, with unique health needs and circumstances — with the eventual goal of seeing many of these individuals transition out of the Medicaid system.

Oklahoma’s Medicaid system is currently a strict fee-for-service arrangement, with little to no emphasis on responsible behavior by the individual. This has led to severe cost overruns.

If Oklahoma doesn’t adopt reforms such as those in HB 1566, the alternative will be large Medicaid reimbursement rate cuts for providers in the state. Reform is urgently needed. Scare tactics intended to forestall reform should be considered as such.

States across the country are reforming their Medicaid systems to control cost overruns while still ensuring quality health outcomes for beneficiaries. One such state is Louisiana, where Gov. Bobby Jindal has led the way in implementing reforms very similar to those in HB 1566.

We encourage Oklahoma legislators to please support HB 1566. Upcoming votes on the measure will be scored as positive on the legislative scorecard OCPA Impact will release at the end of Oklahoma’s 2015 legislative session.