By Constitution Staff

On October 24, more than 313,000 signatures were submitted by the Yes on 802 campaign, taking them one step closer to a vote on the Medicaid initiative in 2020. After working for nearly three months, formed a line winding throughout the building housing the office of the Secretary of State, delivering 313,000 signatures – one box at a time. It was the largest number of signatures submitted for any state question in Oklahoma history.

On July 31, Oklahomans Decide Healthcare began gathering signatures on an initiative petition to expand Medicaid in Oklahoma. Medicaid provides free healthcare at taxpayer expense to lower income families. Medicaid expansion was a major component of Obamacare. Supporters of the initiative petition had until October 28 to collect 177,958 valid signatures of registered voters to place State Question 802 on the 2020 election ballot.

The Obamacare Medicaid proposal, either by legislative action, or by a state question, would be a massive expansion of welfare that could add an estimated 628,000 able-bodied adults to Oklahoma’s welfare rolls. While much of the initial cost of the expansion would be paid from federal funds, it would put Oklahoma on the hook for a state share that could run into hundreds of millions of dollars each year. The federal government would pay 90% of the costs of the expansion in Oklahoma with an estimated $900 million per year, but Oklahoma would have to cover the remaining 10% and would eventually be required to cover a larger share of the program. Oklahoma is one of 14 states that have not signed up for the Obamacare Medicaid expansion.

If approved by voters, the proposal would make the Medicaid expansion a part of the Oklahoma Constitution, which could only be changed by another State Question. The ballot language of the measure says:

“This measure adds a new Article to the Oklahoma Constitution. The new Article would expand Oklahoma’s Medicaid program to include certain low-income adults between the ages of 18 and 65 whose income does not exceed 133 percent of the federal poverty level, as permitted under the federal Medicaid laws.”

The proposal would expand Medicaid eligibility to the entire Obamacare expansion population of able-bodied adults, would access Obamacare expansion funding, and would be subject to all Obamacare regulations. The petition was filed on April 19, but was delayed after a challenge by opponents. But, on June 18, the Oklahoma Supreme Court rejected the challenge, clearing the way for the collection of signatures.

Jonathan Small, president of the Oklahoma Council for Public Affairs (OCPA), issued a statement following the filing of the ballot initiative:

“Make no mistake, expanding Obamacare in Oklahoma will result in the state seeing the same problems as every other state that has gone down this path. Enrollment levels will be far higher than what expansion supporters predict, at significantly higher costs, to achieve significantly lower outcomes than promised. If you doubt it, just look at states comparable to Oklahoma that expanded Medicaid. Cost overruns in Arkansas have topped $1.4 billion, and Kentucky’s ranking on health outcomes remains low, despite Kentucky spending far more taxpayer money on Medicaid.”

Small warned that the initiative could result in tax increases to cover the cost overruns:

“States across the country that have expanded Medicaid have had to resort to tax increases, and the same fate awaits Oklahomans should Medicaid expand. And the growing costs of Medicaid will endanger funding for other government services like education and public safety.”

The 1889 Institute, another Oklahoma policy think tank, has published “Medicaid Expansion in Colorado: An Exercise in Futility.” The paper primarily interprets, in plain language, the conclusions of a study conducted by the Colorado Healthcare Affordability and Sustainability Enterprise Board. Further context regarding the healthcare sector in the nation is provided. In short, the Colorado study showed that hospitals in Colorado became less efficient and raised their prices after Medicaid was expanded.

“This is exactly the opposite result of what we are told will happen if we expand Medicaid under Obamacare,” said Byron Schlomach, author of the report and Director of the 1889 Institute. “The Colorado study and another study out of Arizona make it clear that Medicaid expansion is mainly about enriching its principle advocates, the healthcare industry,” he said.

The study points out that healthcare spending from all sources takes up almost one-fifth of the U.S. economy, that 13 of the 15 highest-paying professions are in healthcare, and that with 90 percent of healthcare being paid for by someone other than patients, there is no true market in healthcare. Schlomach attributes the problems with high prices in healthcare to the lack of market forces brought on by federal policy.

Schlomach said that it does not bother him that people in healthcare professions make a lot of money. “What bothers me is when they claim they are in dire financial straits without more taxpayer funding when, in fact, health care is financially better off than anyone else,” he said. “These studies from Colorado and Arizona show the extent to which the health industry constantly raises prices, not out of necessity, but simply because they can get away with it due to their subterfuge and government policies,” said Schlomach. The publication, “Medicaid Expansion in Colorado: An Exercise in Futility” and other reports on Medicaid health care can be found on the nonprofit’s website at: https://1889institute.org/healthcare.

Gov. Kevin Stitt and Republican legislative leaders oppose the straight Medicaid expansion, as called for in the initiative petition, and pledged to develop an alternative healthcare plan which includes conditions such as work requirements or requiring Medicaid participants to pay a portion of their premiums. A Healthcare Working Group has been formed by legislative leaders and will be similar to the medical marijuana working group that met for 13 weeks last year to develop a way to implement the provisions of State Question 788 into law. But, even if legislation is approved by the Legislature and signed by Gov. Stitt in the next legislative session which begins in February, there is no guarantee that the State Question would be withheld from the ballot. Assuming the required number of signatures are validated when counted by the Secretary of State, and there are no successful challenges to block the proposals, the governor will be required to set the date for State Question 802 to appear on the ballot next year.