Legislators expect some form of Medicaid expansion

Jul. 27--The Oklahoma Legislature's regular session ended this year with several issues hanging in the air, as one bill to expand Medicaid died in the Senate, but has generated talk of a ballot initiative.

A bill addressing Medicaid expansion was actually heard in a Senate committee meeting this year, but failed to make it any further before the session ended.

State Rep. Matt Meredith, D-Tahlequah, said he's happy no funding to state programs had to be cut this year, but he wishes the extra $200 million put back into "the governor's slush fund" would have been put to better use, such as for Medicaid expansion. He added that the state could have paid $140 million to receive the near $1 billion from the federal government for health care expansion.

"We have to do this," said Meredith. "We take federal dollars for our roads and bridges, we take federal dollars for our schools; we need to take these federal dollars. We don't need to raise any taxes or have any revenue raisers. We had the money to do it this year and we chose not to do it."

The state's ability to expand Medicaid comes from the federal Affordable Care Act. State Sen. Dewayne Pemberton, R-Muskogee, said it's a tricky issue for Democrats, but even more so for Republicans, because the $900 million to $1 billion it could have brought in was a part of the Obamacare initiative.

"So the Republican Party was extremely opposed to that," said Pemberton. "I think a lot of that was federal politics that leaked down to the local levels."

Gov. Kevin Stitt has gone back and forth on the health care expansion, but he's also committed to developing a plan to introduce legislation next session. Pemberton said Senate President Pro Tempore Greg Treat set up a task force to discuss expansion, and State Sen. Greg McCortney has a plan he's already proposed once.

"He already has a plan that's he's presented to the Senate caucus back in spring, which would allow us to take that $900 million, but it would not be under the same guides of just accepting the money as a Medicaid expansion," said Pemberton. "It would be set up with certain parameters, the money would go certain ways, and there would be an opt-out. It'd be kind of like what the other states like Arkansas have done, where we would present our own Sooner plan to the federal government of how we would accept the dollars, how we would spend them, and then if the federal government accepted that plan, then we would put that into effect."

Pemberton added that both he and Meredith expect Medicaid expansion to be a hot topic next session. The conversation appears to have gained urgency, though, as the group Oklahomans Decide Healthcare has launched a campaign to collect signatures so Medicaid expansion can be placed on the state ballot in 2020. The Oklahoma Council of Public Affairs questioned the Oklahoma Supreme Court regarding the legality of the ballot initiative, but the court upheld it.

"I know that the AG's office has set the dates for the signatures," said Meredith. "The people who are wanting the bill to be put on the ballot have 90 days to collect the signatures. If they do that, it gets to go on the ballot. I believe wholeheartedly that if it goes to the ballot, it passes. Everyday Oklahomans agree, and it polls very high. We've neglected Oklahomans for years, and years, and years at the expense of big corporations, and it's time we take care of Oklahomans."

Oklahomans Decide Healthcare will start the circulation period to collect signatures July 31, and it will need nearly 178,000 signatures by Oct. 28.

If state lawmakers were to propose legislation to accept the $900 million in federal money during the next regular session, some think it could create a conflict. Pemberton said many legislators aren't sure what will occur if both happen -- the Medicaid question is placed on the ballot, and legislation to expand is proposed.

"Let's say we do a bill that accepts and draws down those dollars, and the ballot issue already has signatures and it's put on the ballot. How would that affect each other?" said Pemberton. "No one seems to know the answer."

Pemberton said if the measure is placed on the ballot and it passes, it would mean a chance to the state constitution, and "you can't overrule a constitutional change by legislation." He also said the state may attempt to put certain "parameters" on the ballot measure contingent upon its passing.

He said many don't want to see the ballot to pass and it become a "free-for-all like we had with the medical marijuana."

"The ballot measure was so open that it really was not regulated very well," said Pemberton. "This last year, I think we passed 10 or 12 bills trying to whittle it back down to an organized medical marijuana legislation that we could get our heads around. These ballot measures sometimes are short and they don't take into account all of the nuances, the issues, and all of the things that are going to come into play. It requires dozens of bills and legislation to clean stuff up. We may try to clean it up beforehand so we have a functional system before it actually hits the ballot."

A query to Young Republican Chair Justin Kennedy was not returned. Dell Barnes, vice chair of the Cherokee County Democrats, said he was unavailable to answer questions.

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