OKLAHOMA CITY — Just how grim the state’s budget situation has become was apparent Wednesday morning as the state House of Representatives discussed and ultimately agreed to a bill that would cut 111,000 Oklahomans, most of them women, from Medicaid.
House Bill 2665, by Rep. Doug Cox, R-Grove, instructs the Oklahoma Health Care Authority, which administers the state’s Medicaid program, to request a federal waiver that would allow it to exclude all able-bodied adults younger than 65.
Currently, Cox said, about 111,000 single, non-disabled parents earning less than $9,500 are covered by SoonerCare, Oklahoma’s version of Medicaid. Cox said 77,000 of those are women.
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Such a move would save the state an estimated $130 million a year, according to the bill’s fiscal impact statement, but cost $203 million in federal matching funds. Cutting those recipients without the waiver would endanger Oklahoma’s entire Medicaid program and $3 billion a year in federal funds.
Through more than two hours of discussion and debate, Cox said he was not happy about the proposal but that he believed it was the only alternative.
The worse alternatives, he said, could include eliminating prescription drug coverage — a route that would not require a waiver — and lowering reimbursements to the point that health care providers no longer accept Medicaid patients, and the closing of many of the state’s nursing homes.
Democrats countered that the loss of $200 million in federal funding and the higher rates of uncompensated care are likely to close some hospitals, and questioned why Cox’s bill was the first addressing the state’s budget situation to reach the House floor.
They also wanted to know why the Republican-controlled state government had declined a Medicaid expansion offered by the Affordable Care Act, or “Obamacare,” a provision that was intended to address such situations.
“I am actually working with some folks to design something,” Cox said.
Cox is among a handful of Republicans who have publicly advocated that Oklahoma adopt a program similar to Arkansas’, in which expanded Medicaid funding is used to privately insure low-income individuals.
Democrats Eric Proctor of Tulsa and Mike Brown of Tahlequah questioned the morality of cutting Medicaid without addressing business incentives.
“The choice is not really about whether we help (one person) or someone else,” Proctor said. “It’s about whether we help CapitolOne or some other corporation or the poorest people in the state.”
The bill passed 65-34, with four Republicans joining all 30 Democrats in opposition. Two members did not vote.
Also Wednesday, the House approved Senate Bill 1570, transferring the Will Rogers Memorial to the Oklahoma Historical Society. The measure passed 85-9, and returned to the Senate.
