May 16, 2016 1:56 pm


Gov. Mary Fallin (R)

In a surprising about-face, Oklahoma Gov. Mary Fallin (R) and the state’s GOP leaders are considering embracing a key tenet of Obamacare and expanding Medicaid to offer health insurance coverage to additional low-income Americans.

The state’s overwhelmingly Republican state lawmakers are considering the Oklahoma Health Care Authority’s proposal to move 175,000 people off Medicaid and into Obamacare’s subsidized private insurance markets, making room for new Medicaid enrollees. If state lawmakers and the Obama administration approve the plan, the federal government will cover 90 percent of the cost — reviving the state’s struggling Medicaid program with an influx of federal Obamacare dollars.

To fund the state’s 10 percent slice of the bill, the plan calls for a $1.50-per-pack tax on cigarettes.

If the state legislature doesn’t act, the state’s Medicaid agency says it will have no choice but to cut doctor reimbursements by 25 percent. Nico Gomez, CEO of the state Medicaid agency, warned state lawmakers that such cuts would be “cataclysmic” for the 1 in 5 low-income Oklahomans who are currently enrolled in Medicaid.

“I’m afraid many providers will close their doors to our patients,” he said during a meeting in the state capitol. “In some cases, especially in rural parts of our state, health care professionals will have to move their business to larger communities in order to survive financially.”

The cuts would put rural health care providers like McCurtain Memorial Hospital out of business. “A 25 percent cut [to Medicaid] would shutter our doors for good, leaving 33,000 people without access to health care,” CEO Jahni Tapley told the Houston Chronicle.

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Shuttering rural hospitals is a particular threat to women’s health. Nearly every pregnancy that McCurtain Memorial delivers is billed to Medicaid. When hospitals like that close, women may be forced to drive hundreds of miles to deliver, endangering their lives and their children’s lives in the process.

Gov. Fallin has marketed the plan to conservatives as a “Medicaid rebalancing,” hoping to sidestep the Obamacare-associated phrase “Medicaid expansion.” Her plan promises to bring federal dollars to Oklahoma without changing net Medicaid enrollment.

Conservative groups are resistant to expanding the Medicaid program, saying that this policy almost always goes over budget and leaves taxpayers to foot the bill. The right-wing group Americans for Prosperity — backed by the anti-Obamacare Koch brothers — are already mobilizing against Fallin’s proposal.

Thanks to GOP lawmakers’ unwillingness to enact this aspect of health care reform, more than 3 million poor uninsured adults in the country currently fall into a “coverage gap,” unable to access affordable insurance whatsoever — and 90 percent of that population lives in the South.

Over the past year, more GOP-controlled states have started coming around on this particular Obamacare policy. If Oklahoma lawmakers eventually agree to expand Medicaid, they will join Republican politicians in states like Tennessee, Arkansas, and Utah who have also sought to find a compromise in this area.

Cory Herro is an intern at ThinkProgress.

Oklahoma GOP Does an About-Face on Medicaid Expansion
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