By Conrad Dudderar
Senior Staff Writer
More than 57% of Canadian County voters casting ballots in the June 30 election opposed expanding Medicaid in Oklahoma.
However, State Question 802 – the Oklahoma Medicaid expansion initiative – passed statewide by a narrow 1% margin totaling about 6,500 votes.
With all 1,948 precincts reporting across Oklahoma, the final vote tally was 340,279 “yes” and 333,761 “no.”
Passage of S.Q. 802 effectively expands Medicaid eligibility to Oklahoma adults between 18 and 65 with incomes at or below 138% of the federal poverty level under the Affordable Care Act (ACA).
Interestingly, a strong majority of Oklahoma voters on election day opposed the proposition – with 245,227 yes votes and 299,712 no votes cast.
But the initiative petition had received overwhelmingly support among absentee mail voters statewide, with 76,093 voting yes and only 18,521 voting no.
With votes tallied in 50 Canadian County precincts, the county result in the S.Q. 802 election was 10,059 yes votes (42.71%) and 13,492 no votes (57.29%).
Because of S.Q. 802’s passage, Canadian County Democrats’ Chair Jody Harlan said people who couldn’t work because they had a “cure-able” medical condition will be able to get needed care and return to jobs, pay taxes and keep their homes.
When Oklahoma lawmakers several years ago declined to accept federal Affordable Care Act (ACA) funding, Harlan said “lower-income working people were left in the middle.”
These Oklahomans didn’t get health insurance through their jobs and weren’t eligible through the ACA exchange program.
“Now that’s changed,” Harlan said after S.Q. 802’s approval. “I believe it will create jobs in healthcare and related industries.
“There are areas in Oklahoma where, if somebody is injured or has a heart attack, it’s an hour to healthcare because their rural hospitals have closed.”
Harlan, of Yukon, addressed Gov. Stitt’s recent vocal opposition due to his concern about the cost of expanding Medicare in Oklahoma.
“Anytime you can spend $1 and get a $9 match for something as critical as healthcare, that’s an investment we should make,” Harlan argued.
She contended that other states that have expanded Medicaid have found the money.
“It’s not about the cost,” Harlan said bluntly. “It’s about loss of control. The Legislature did not want to invest in affordable care, and they didn’t like the so-called ‘Obamacare’. They made an emotional decision that rejected a very practical, fiscally responsible decision.
“And the people said ‘no.’ And not only ‘no’ but ‘h*ll no’.”
Some 313,000 Oklahomans signed the initiative petition to place S.Q. 802 on the ballot – the most in state history, Harlan noted.
COUNTY VOTERS ‘WERE RIGHT’
State Rep. Jay Steagall, R-Yukon, commended the 57% of Canadian County voters who opposed this constitutional amendment to expand Medicaid eligibility under the ACA.
“I think our voters here in Canadian County were right,” said Steagall, who represents state House District 43. “I think the people who voted against the measure had some good information to base their vote on.
“I think they understand what kind of implications this is going to have on our state budget. Last year, we had to deal with basically a $1.4 billion shortfall. We were able to minimize cuts to state agencies because we had money in our ‘Rainy Day’ fund and some other money was available through different channels.”
Oklahoma was already looking at a “flat budget” – at best – next year, Steagall noted.
“But now we’re adding a cost, potentially, that we don’t really know the full extent of what it’s going to be,” he said of 802.
Rep. Steagall referred to some estimates that indicate Medicaid expansion would cost the State of Oklahoma about $200 million, covering 10% of the total price tag.
“But in every state where Medicaid expansion has been implemented, the actual cost has been two to three times higher than what the estimates were,” the state legislator noted. “There’s no ‘cap’ on what that 10% cost could actually mean to the state.”
Also of genuine concern to the District 43 rep is the federal government taking control of Oklahoma’s state budget with passage of this measure.
“The feds control the federal poverty level – the 138% number implemented through 802 that makes this group of people eligible,” he said. “It’s their program that we’re buying into, so we’ve basically just handed them all of our state budget and we’re left to deal with whatever we can money-wise to fund all of our core services.”
Canadian County citizens who cast no votes had it right, Steagall argued.
“It wasn’t because the voters don’t have a heart for those who go without (health) insurance,” he said. “It’s because they understand the financial implications of this and how it’s going to affect how we operate as a state.”
With Oklahoma relying so heavily on the oil and gas industry rebounding, state leaders already are in a tight spot when it comes to the economy.
Lawmakers face tough decisions about which state agencies may see budget cuts and how much they will be.
“We’re not seeing an increase in state revenue as a result of Medicaid expansion,” Rep. Steagall said. “It’s another cost that we’re adding.”
Some 54% of voters in House District 43 opposed S.Q. 802, which failed in 11 of 12 Yukon-area precincts.
More than 7,000 HD-43 voters cast ballots in the June 30 election, with 3,226 voting yes and 3,792 voting no.
RURAL/URBAN VOTE SPLIT
Harlan, the Canadian County Democrats’ chair, was surprised the June 30th election was so close after such strong voter favor during absentee and early voting.
“There was definitely a split between rural and urban areas, with rural opposing and urban areas being more supportive of 802,” Harlan said. “That surprised me, with all the rural hospitals that have closed lately. People must surely realize that part of the reason for that is the inability of some people in the rural areas to pay for their healthcare.
“The uninsured are showing up at the emergency rooms with conditions that could have been treated less expensively earlier.”
Harlan contended Oklahoma voters had more common sense than the state’s elected leaders on this issue.
Controversy over S.Q. 802 reflected a lack of trust about the ACA – also known as “Obamacare”, she surmised.
“But hundreds of thousands of Oklahomans were caught in a gap,” Harlan said. “When Affordable Care was introduced, the designers didn’t imagine that a state would turn down a $9-to-$1 federal match that would recover tax dollars we’ve already paid.”
The U.S. Supreme Court ruled against making the act mandatory, which would have allowed states like Oklahoma to receive federal funding to expand Medicaid.
“That left some lower-income working people in a gap,” Harlan said. “They didn’t make enough to qualify for Affordable Care because the system expected the state to take the Medicaid match.”
Harlan believes Medicaid expansion will create jobs for more tax-paying Oklahomans.
“I think, in the long run, Oklahoma will receive financial benefits other than the billion dollars in federal tax money that’s our money,” she said. “We sent it to Washington, and it was going to other states for their healthcare.”