Health Care

Health care working group membership announced

July 30, 2019

Ray Carter

The co-chairs of a newly formed legislative health care working group are among the leading proponents of Medicaid expansion in Oklahoma.

Rep. Marcus McEntire, R-Duncan, and Sen. Greg McCortney, R-Ada, will co-chair the task force, legislative leaders announced in a release issued Monday.

In the announcement, House Speaker Charles McCall, R-Atoka, said the working group will “bring everyone together—patients, providers, policy experts, insurance carriers, facilities, and state agencies—and find a way forward. That discussion must include everything, not just Medicaid expansion, and it will need to continue until we have a solution that works for our citizens' unique needs.”

Senate President Pro Tempore Greg Treat, R-Oklahoma City, said he was “confident this group will take a serious look at the issue and give useful recommendations for the Legislature to consider as we work to improve Oklahomans’ access to quality, affordable health care.”

Under the federal Affordable Care Act, commonly referred to as “Obamacare,” states that expand their Medicaid programs to include able-bodied adults earning up to 138 percent of the federal poverty rate are rewarded with a 90-percent federal matching rate. That’s in comparison to the lower federal-matching rate provided to states for covering the existing Medicaid population of aged, blind, and disabled, where the matching rate ranges from 50 percent to around 75 percent.

McEntire and McCortney have been the most outspoken Republican proponents of growing the size and cost of Oklahoma’s Medicaid program by adding able-bodied adults to it. In April, while addressing a rally of mostly liberal activist groups, McEntire said legislative efforts to expand Medicaid had been ongoing since before the 2018 legislative session.

“The House and the Senate have been working on a plan for about a year-and-a-half now,” said McEntire, who chairs the House Appropriation and Budget Subcommittee on Health. “It’s in process. Most of the details right now are embargoed until we get the support we need. But we have been working and we’ve been working hard. I’ve put a lot of blood, sweat, and tears into the plan that hopefully we’ll be able to unveil.”

During the 2019 legislative session, McCortney authored legislation to expand Medicaid. That bill, based on Arkansas’ Medicaid expansion, cleared a Senate committee but did not proceed further. The Arkansas plan uses Medicaid dollars to buy private policies that must be as all-encompassing as traditional Medicaid and involve little financial buy-in from recipients.

Some supporters of Medicaid expansion have said they can pass an “Oklahoma plan” that does not hew to the broad requirements of federal law under the Affordable Care Act. Those claims were badly undermined when the Trump administration, no fan of the ACA, nonetheless rejected a waiver request from Utah officials that would have allowed them to receive the 90-percent federal matching rate for a partial expansion of Medicaid to those earning up to 100 percent of the federal poverty level.

The proposed expansion of Medicaid in Oklahoma would add up to 628,000 able-bodied adults to the welfare program at an estimated cost to Oklahoma state taxpayers of as much as $374 million annually.

Arkansas’ Medicaid expansion, which was the model for McCortney’s plan, has been criticized for being even more expensive than traditional Medicaid expansion. A 2016 review found traditional Medicaid expansion would have cost around $3,000 per person annually, while the Arkansas expansion was projected to cost $6,400 per person.

The 20-member health care working group includes 18 legislators and two representatives of the governor’s office. The House and Senate have nine appointees apiece. The partisan breakdown of legislators is 14 Republicans and four Democrats.

The Democratic caucuses in both chambers have called for Medicaid expansion. Three of the Senate appointees to the working group voted for McCortney’s Medicaid-expansion plan in the 2019 session, and one of Gov. Kevin Stitt’s appointees to the working group—Oklahoma Deputy Secretary of Health Carter Kimble—has also voiced support for Medicaid expansion. Combined with McEntire and McCortney, 10 of the working group’s 18 members have either voted for or voiced support for Medicaid expansion.

The press release said the working group would “begin meeting on a weekly basis in August.”

The working group’s meetings will occur even as a statewide initiative petition is gathering signatures to put Medicaid expansion on the ballot in 2020. That measure, if approved by voters, would make Medicaid a constitutional right for able-bodied adults. The initiative petition will supersede any related legislation that could be passed by lawmakers in the coming year.

The working group’s members include the following: