Medicaid expansion would cut uninsured rate, keep hospitals open, Oklahoma medical providers say

Jun. 7--Expanding Medicaid would reduce Oklahoma's high rate of uninsured people and furnish "critical funds to keep hospitals open and health care staff employed," Oklahoma health care providers told the state Supreme Court.

Defending an initiative petition filed to put Medicaid expansion on a statewide ballot, the medical professionals predicted the petition would be supported by a majority of Oklahomans.

"The initiative petition will allow the citizens of Oklahoma to demand that the state accept the federal dollars that 36 other states and the District of Columbia have already accepted in order to bring Medicaid coverage to many of their fellow Oklahomans who remain uninsured," the health care providers said in a brief filed this week.

The brief was filed by the Oklahoma Hospital Association, the Oklahoma State Medical Association, the Oklahoma Osteopathic Association, the Oklahoma Nurses Association and the Saint Francis Health System.

Medicaid is a federal-state health insurance program designed primarily for low-income children and parents. Under the Affordable Care Act, states can expand eligibility to cover people with higher incomes, including adults without children.

According to the medical groups, expanding Medicaid in Oklahoma would cover between 153,000 and 196,000 additional people, many of them uninsured, working adults.

The expansion would provide an estimated $900 million a year in federal money and cost over $100 million a year in state funds.

"Accepting $9 in federal funds for every investment of $1 by our state is a much better match than many federal programs offer and like other federal partnerships would boost our economy and increase employment," the health care providers told the court.

"Health care is a major business sector in our state and Medicaid expansion will reduce the uncompensated care costs of our healthcare business."

The health care providers are siding with the filers of the petition, which is under protest at the Oklahoma Supreme Court.

The Oklahoma Council of Public Affairs, a conservative think tank in Oklahoma City, filed the protest, contending the wording of the petition is inaccurate and that the proposal is unconstitutional. The council had objected to the health care providers submitting a brief in the case, but the Supreme Court allowed it.

In a brief filed this week, the council said no other state had put Medicaid expansion in its constitution, as the Oklahoma petition would.

"Oklahoma would be obligated to provide medical assistance to adults at or below 138% of the federal poverty level regardless whether Congress continues to pay a large portion of the costs," the council argued.

"Congress would dictate how much money actually leaves Oklahoma's treasury. Moreover, federal bureaucrats set the federal poverty level, which would determine Medicaid eligibility. The Oklahoma Legislature would merely be a conduit to finance the federal government's policy decisions. This is unconstitutional."

The Oklahoma attorney general's office has told the Supreme Court that the Medicaid expansion proposal is constitutional. However, it agrees that the wording must be tossed out and rewritten.

The petition's gist, or summary, says Medicaid eligibility would be expanded to people with an income level of 133% of the poverty line. However, the petition would have the practical effect of expanding Medicaid to certain individuals with income below 138% of the poverty line, the attorney general's office told the court.

The council protesting the petition says the gist is also inadequate because it doesn't inform people that Oklahoma will be obligated to pay for medical services under the expansion.

The Supreme Court is scheduled to hear oral arguments in the protest on June 18.

The petition seeks to put the question before Oklahoma voters in the next general election, which would be November 2020. Supporters would have to gather nearly 178,000 signatures to qualify the question for the ballot.

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