Medicaid expansion petition challenged by Oklahoma think tank

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OKLAHOMA CITY - A court challenge filed this week claims putting the question of Medicaid expansion on the 2020 ballot may be unconstitutional and could pose a possible conflict with federal law.

"The most vulnerable in Oklahoma and voters deserve to know the truth of what they’ll be voting on," said Jonathan Small, president of the Oklahoma Council of Public Affairs.

The OCPA filed the challenge in the Oklahoma Supreme Court this week, less than a month after an initiative petition was filed to allow Oklahoma voters to decide whether to expand the federal-state health program to cover more low-income residents. That initial petition was filed by attorneys with the Oklahoma City-based law firm Crowe & Dunlevy.

Travis Jett, an attorney representing the OCPA, said there are two main legal arguments against the initiative petition.

"The first is based on separation of powers. There’s a significant delegation of legislative authority from the state of Oklahoma to Congress. Congress would ultimately control the eligibility and the costs that can be born by the state of Oklahoma," Jett said. "The second basis is based on the conflict with federal law. Federal law requires that, if a state chooses to expand Medicaid coverage, it must expand that to adults at 138 percent of the federal poverty level. This initiative petition would extend it adults at 133 percent."

Small said the expansion would cost the state about $374 million annually.

"The average cost for Medicaid expansion per person across the country is right at about $5,900," he said. "The Healthcare Authority has said that there are approximately 628,000 able-bodied - most of them, working adults - that would fit the income category."

Rep. Forrest Bennett, D-Oklahoma City supports the idea of Medicaid expansion and claims the logic behind the challenge is flawed.

"They’re not challenging it on legal grounds as much as they’re challenging it on philosophical grounds," Bennett said. "This is an organization that believes in quite of bit of individual responsibility, and that’s a great virtue but we are talking about families that are working and yet still not able to pay the bills – let alone get access to health insurance."

Bennett points to the number of uninsured Oklahomans. The latest data to the Oklahoma Healthcare Authority shows nearly 542,000 uninsured Oklahomans as 2017.

"The emergency room around the corner from my house SW 44th and Western is one of the busiest emergency rooms in the state, because we have a high rate of uninsured families in our area and they know, if they want to get care, they can go to the emergency room and do that," Bennett said. "We can argue all we want about the merits of that policy, but that’s what happening right now and the best way to relieve pressure on emergency rooms and lower the costs of hospitals providing that uncompensated care is to expand Medicaid."

In response, Small said, "First of all, the state already gives billions of dollars for healthcare. Also, Oklahoma citizens give tax abatement privileges to the more than $12 billion in annual revenue to hospitals in Oklahoma. Most of them say they’re non-profits that exist to serve the boards. So, my question is – why aren’t they treating those people better when they come to hospitals given the fact we’re already giving them over $12 billion a year between what government transfers to them and then what people pay in the private sector?"

A hearing date on the matter has not been set yet.

Melanie Rughani, an attorney with Crowe & Dunlevy, told News 4 on Friday that they cannot comment pending litigation, but she said their brief will speak for itself. The brief has not been filed yet, but she said the Oklahoma Supreme Court will likely issue an order setting a date within the next few weeks for a response.

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