Republican former House speaker endorses Medicaid expansion for Oklahoma

Oct. 1--Kris Steele, a Republican who was speaker of the Oklahoma House during a period of intense GOP resistance to the Affordable Care Act, came out Monday night for a key feature of that health care law.

Speaking at a forum on mental health care in south Oklahoma City, Steele endorsed Medicaid expansion. In fact, he recited the main points of those now pushing for a state ballot question on expanding the state-federal health care insurance.

"When people are healthier, they tend to commit less crime," Steele said. "When people are healthier, it tends to improve the quality of life.

"The reality is this: Collectively we are a rural state. Health care in rural Oklahoma is in crisis. If there's a way to bring some of our tax dollars back home to benefit the people who live in our state, I don't know why we wouldn't do that."

Asked about his new position on Medicaid expansion, Steele said Monday night, "I totally acknowledge my evolution on this issue."

Steele was speaker of the Oklahoma House in 2011 and 2012, the two years following enactment of the Affordable Care Act, often referred to as Obamacare.

Republicans, including then-Gov. Mary Fallin, frequently and harshly criticized the law. In 2010, Oklahoma voters approved a symbolic state question enshrining opposition to health care "mandates" in the state constitution.

In 2012, the U.S. Supreme Court upheld the Affordable Care Act but ruled that Medicaid expansion was optional for states. States controlled by Republicans, including Oklahoma, refused to set up their own health care exchanges and refused to expand Medicaid to more low-income people, even though the federal government would pay 100 percent of the expansion costs in the first years. Fallin announced after the Supreme Court decision that Oklahoma would not expand Medicaid.

Amber England, who is heading the campaign to put Medicaid expansion on the ballot in Oklahoma next year, said Tuesday, "For whatever reason, folks in charge here just didn't want to look at the issue."

Steele said Monday night that Republican hostility to then-President Barack Obama and his signature health care law was probably a factor in the opposition to expanding Medicaid.

Steele said he had pushed through a bill calling for a study of Oklahoma participation, but that the Senate never voted on it. Also, he said, he worked on expanding the Insure Oklahoma plan to help small businesses provide coverage to employers.

Steele is now executive director of The Education and Employment Ministry and a prominent advocate for criminal justice reform. He said he had seen in his work how health care improves the lives of the working poor and others.

England said, "He's in a unique position in the criminal justice reform space where he sees the direct correlation to our prison population and the lack of access to treatment and care."

England said Republican states, either through government action or statewide ballot initiatives, have been adopting Medicaid expansion. Oklahoma is now one of 14 states that has not done so.

"As we get further and further and further into this campaign, those labels really come off of people," she said. "It's not about Democrats and Republicans. It's about Oklahomans helping Oklahomans and understanding this is the right thing to do and it's the fiscally responsible thing to do ... If we can get back our federal dollars, we should do that."

Gov. Kevin Stitt, a Republican, is against a straight Medicaid expansion, as are some other current Republican legislative leaders who are conducting a study to determine how best to tailor expanding the program to Oklahoma.

England said the campaign for a statewide ballot question will have the 178,000 signatures before the Oct. 28 deadline.

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