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Oklahoma Supreme Court to hear arguments over Medicaid petition

 The Journal RecordJune 12, 2019

OKLAHOMA CITY – Opponents and proponents of Medicaid expansion in Oklahoma will appear before the state Supreme Court on June 18.

That’s the date that has been set for oral arguments to be heard over whether an initiative petition calling for a statewide vote on the issue should be allowed to go forward.

Oklahoma Secretary of State Michael Rogers’ office received notice on May 3 that Oklahomans who favor expanding Medicaid hope to garner enough signatures on a petition to prompt the court to order a state question on ballots in an upcoming general election. A legal challenge was filed days later by the Oklahoma Council of Public Affairs.

The petition proposes expanding Medicaid in Oklahoma to low-income adults 18-65 with incomes below 133% of the federal poverty level. Hundreds of millions of dollars and the health care of tens of thousands of Oklahomans are at issue. If the state moves to expand its Medicaid program and commits $100 million to the effort, the federal government has committed to contributing $900 million.

Most other states have expanded programs to better address the health care needs of the poor and uninsured, but Oklahoma, Texas and several others haven’t. Many lawmakers feel that by allowing far more people to enroll in Medicaid they would be committing taxpayers to costs that could become a huge burden in the future.

On the day of its court challenge of the initiative petition, the OCPA said ballooning costs eventually would harm the most vulnerable Oklahomans. Expansion effectively would make taxpayers responsible for the health care needs of an estimated 628,000 able-bodied adults, OCPA President Jonathan Small said. If state taxpayers have to pay just 10% of the average Medicaid costs of those enrollees, their annual bill would be $374 million.

The initiative petition was challenged on grounds that terms proposed by those who would expand Medicaid in Oklahoma don’t match with terms called for by the federal Affordable Care Act, and inconsistency with federal law would not be allowed. Oklahoma Attorney General Mike Hunter has weighed in, saying that while challenges to the petition’s constitutionality should be rejected, the “gist” of it includes inaccuracies that should not withstand the court’s scrutiny.

This week, the Oklahoma Hospital Association, Oklahoma State Medical Association, Osteopathic Association, Nurses Association and Saint Francis Health System filed a brief with the court outlining why the health care organizations feel the petition process should be allowed to proceed.

“Individuals on the front line of health care delivery in our state see daily those individuals who suffer consequences of Oklahoma’s failure to accept benefits of expanded Medicaid coverage,” their brief states. “All Oklahomans are absorbing the costs of care for the uninsured today, but this cost falls disproportionately on health care providers. Too often, hospitals, physicians, advance practice nurses, and other medical professionals are not paid for the care they render because many Oklahomans have no source of payment.”

The organizations also assert that health care costs paid by the state if it expands Medicaid might not rise at all.

“The data available from states that have accepted Medicaid expansion show that those states have not experienced an unaffordable burden on their state budgets. Contrary to the (OCPA’s) assertion, many expansion states have experienced budget savings. Expanded Medicaid covers many services the states were already paying for directly from state budgets, such as mental health treatment, substance use disorder treatment, care for incarcerated individuals nearing release, and public health services.”

In Oklahoma, for an initiative petition to succeed in forcing a state question onto a ballot, signatures garnered must equal 15% of votes cast in the previous gubernatorial election. That means 177,958 signatures would be required to force the Medicaid expansion question on an upcoming ballot.

No signatures can be gathered as long as court challenges are pending. Signature collection would extend for 90 days after any challenges are resolved.

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