OKLAHOMA HEALTHCARE: Stitt shuffles Medicaid stance

Feb. 10--OKLAHOMA CITY -- Republican Gov. Kevin Stitt, just one month into his tenure as Oklahoma's chief executive, said he has been busy learning all he can about how best to govern the state. That learning process also spurred a change in Stitt's viewpoint on expanding Medicaid -- where he is now saying he could be open to the idea.

"I'm not going to say never. I need to learn more about it," Stitt said in response to a question about Medicaid expansion during a meeting with members of the Oklahoma Press Association on Thursday.

The governor's comments are strikingly different from those he shared on the campaign trail, where he was firmly against the expansion of Medicaid in Oklahoma under the Affordable Care Act. During Monday's State of the State address to Oklahoma lawmakers, Stitt said he was reluctant to accept more federal dollars for healthcare.

"While Medicaid expansion currently stops at a 90 percent federal match, we cannot assume that it will remain this high forever," he said Monday. "The estimated $150 million price tag today for Oklahoma to expand Medicaid could leave us down the road fronting more than $1 billion when the federal government pulls back on its commitment. They've done it before and they will do it again."

Thursday, Stitt clarified that while he's not going to take anything off the table, he does not believe expanding Medicaid is something that needs to be done until he looks at the broader picture.

"As it stands today, no, I'm not going to accept Medicaid money," Stitt said.

Medicaid expansion would provide health insurance to tens of thousands of uninsured adults. Under current Oklahoma law, non-disabled adults must earn less than $4,621 annually to qualify for Medicaid, according to a report from the Associated Press. Under an expansion, an adult could earn up to about $23,100 and still receive coverage through Medicaid.

A study shows about one in seven Oklahomans is uninsured, giving Oklahoma one of the highest uninsured rates in the country. Several rural hospitals have been shuttered in recent years, and many others are currently operating at a loss and are at risk of closure, the Associated Press reported.

Stitt said he must first have greater control over the Oklahoma Healthcare Authority before he would consider any expansion of Medicaid.

"If we can't oversee that agency that already spends $5.5 billion, how do I know that another billion dollars is actually going to get to the rural hospitals and get to nursing homes," Stitt said Thursday.

With the condition of having more oversight over the Healthcare Authority, Stitt left the door open to exploring Medicaid expansion, acknowledging that 38 states have accepted additional Medicaid dollars, where Oklahoma has not.

"We are one of the few states that doesn't," Stitt said. "I think there is a lot of data we can look at on healthcare outcomes and figure out how to move the needle. Also, you have to follow the money. The hospitals definitely want it, because that's a billion dollars more that goes into healthcare. You have people who definitely want it and are pushing for it."

However, Stitt cautioned that while he is open to more federal dollars for healthcare, he is looking out for all Oklahomans, making sure there are no unexpected strings attached to the funding.

"I love the fact that we can get federal dollars. I want to get federal dollars, whether that be for roads and bridges or the healthcare system," Stitt said. "We have to be very careful about what are the mandates and the handcuffs that come with that. When you expand something, you put more people into a system... It is hard to get them off. I want to be, as the governor -- very, very careful about that and at the same time help my rural hospitals and figuring out how to get more dollars there."

The issue of Medicaid expansion has been a point of contention for Oklahoma Republicans. Many see the benefit of increasing federal funds to the state's health system, but have also demonized the Affordable Care Act on the campaign trail -- as Stitt did.

"I'm not going to say never. I need to learn more about it," Stitt said Thursday. "But I'm also thinking about what's best for all 4 million Oklahomans and the future of Oklahoma. You've got to make sure you have someone looking at the big picture."

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