Oklahoma paid $248,000 for this?
That was the first question -- admittedly cynical -- that popped into mind last week when a much-anticipated report on health care for Oklahoma's working poor was unveiled formally.
The Leavitt Group, headed by former Utah Gov. Mike Leavitt, urged Oklahoma to tap ObamaCare dollars to expand the state's successful Insure Oklahoma program rather than federally-sponsored Medicaid.
Leavitt suggested Oklahoma, over the first 10 years, could save in the neighborhood of $464 million and insure somewhere between 187,000 and 275,000 not currently covered.
The strategy seemed so simple that it begged another question: Why didn't someone in state government leadership think of that?
Well, someone did: Sen. Brian Crain, R-Tulsa, and Rep. Doug Cox, R-Grove. The Leavitt plan mirrored many of the specifics in Crain's and Cox's Senate Bill 640 that died in the waning days of the recent legislative session.
So why did taxpayers need to pay Leavitt $248,000 to tell us what Cox, an emergency room physician, and Crain, the Senate Health and Human Services Committee chair, already knew -- and proposed?
It's all part of a delicate political dance involving Gov. Fallin, Senate President Pro Tem Brian Bingman, House Speaker T.W. Shannon, and far-right extremists in the Legislature who don't want anything to do with an evil federal government or a Kenyan-born president.
It was in 2011 when Fallin thought she and legislative leaders -- including then Speaker Kris Steele -- had a deal to accept a $54 million federal grant to set up a state-operated health insurance exchange under the Affordable Care Act.
Under pressure from wingnuts in his caucus, Bingman abruptly yanked the rug from under Fallin and Steele, meaning the grant -- which taxpayers had already paid for -- would be spent in other states.
Fallin learned a powerful lesson: With re-election in 2014 at the top of her agenda, she wasn't about to do anything to cross the Tea Party crowd.
But she needed a face-saving strategy, so Leavitt's firm was hired to develop an Oklahoma plan that would give the illusion that Oklahoma was going its own way and not getting in bed with evil Uncle Sugar.
It mattered not one whit to Speaker Shannon and the fed-haters that thousands of Oklahoma's working poor were on the verge of losing health insurance -- the feds denied a waiver that would have permitted Insure Oklahoma to continue after Dec. 31. Or that hundreds of thousands of others would remain without coverage. Or that Oklahoma's hospitals were on the verge of bankruptcy.
All that mattered was devotion to a twisted ideology that declared that we're not going to take money from a debt-riddled government.
Never mind, of course, that Oklahoma is beneficiary of more federal spending per capita than just about any other state and would dry up without it.
So now that Leavitt has come back and advised Oklahoma to do what Crain and Cox proposed, where does the state go?
First, there's no guarantee the feds would approve the plan, but without the governor, Senate president, House speaker and Legislature on board, there's zero chance of enacting an Oklahoma-centric plan.
The problem clearly is Speaker Shannon. He was elected speaker on the strength of the tea partiers in the state House. He's probably not interested in crossing a core constituency, given his ambitions for higher office.
Cox believes that if the governor supports the proposal, the speaker will, too.
It's hard to imagine Fallin wouldn't be on board.
Hiring Leavitt's consulting firm was her idea, and the plan would give Oklahoma the best of both worlds: access to massive federal financial support and the appearance of state independence via Insure Oklahoma.
Though it was Bingman who torpedoed the exchange grant two years ago, most eyes are on Shannon as the key figure in whether Oklahoma can move forward with the Leavitt plan and win federal approval for its implementation.
As this year's session reached its final days, Shannon rejected Fallin's efforts to save Insure Oklahoma, jeopardizing healthcare for 9,000 working poor.
At the time, Shannon blamed the Obama Administration's waiver denial, adding: "This is exactly what happens when government goes into the health-care business. "
Shannon's remarks were duplicitous. As state Rep. Brian Renegar, D-McAlester, points out, Shannon's belief that government ought not have a role in subsidizing health care contradicts the speaker's view that government can and should help business and attract new industry to the state.
"As a small business owner who provides health insurance to my employees through Insure Oklahoma, the speaker's position that government has no role in healthcare is absurd," says Renegar, a veterinarian.
"Two of my employees have insurance for the first time because I can provide it for them through a government-subsidized program. If you can cover your family with health insurance, you know the financial security it provides. And if you can't, you know the stress it causes.
"As an employer, it helps me sleep at night knowing I can help my employees with healthcare because they help me with their work every day," he said.
Moreover, Renegar notes, thousands of Oklahomans rely on government-subsidized health insurance: Tricare for military families, Medicare for seniors, SoonerCare for low-income residents, and tribal health care services.
The Leavitt strategy appears to have managed something once thought impossible: It united Democrats -- even liberal Democrats -- and Republicans who agree on the importance of expanding health insurance to as many Oklahomans as possible and the folly of rejecting billions of dollars in federal aid that simply will go to other states.
Moreover, the consultants emphasized that leveraging federal dollars to push more of Oklahoma's working poor into health insurance exchanges -- where they could affordably purchase coverage from private companies -- helps encourage personal responsibility.
Private -- not government -- insurance. Personal responsibility. That should be red meat for the uber-right.
But the fact is, anything that can be remotely tied to ObamaCare is toxic in Wingnut World, which means it's toxic within the GOP.
The Leavitt blueprint is a good one, given the current state of Oklahoma politics. Whether that's enough to finally persuade our elected leaders to put the needs of the working poor over politics remains to be seen.
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