Is Fallin Next? GOP Governors Accept Medicaid Expansion

Image of Mary Fallin

Is it only a matter of time before Gov. Mary Fallin ends the anti-Obamacare political charade and allows the state to expand its Medicaid program with federal dollars?

Fallin’s current contradiction is glaring. She’s overly concerned with the smoking habits of many of her constituents and says she wants a healthier state, but when it comes to providing them with more access to health insurance she turns into a stubborn ideologue.

That could change now that Florida Gov. Rick Scott, a prominent Republican, has announced his state will expand Medicaid coverage to people with incomes up to 133 percent of the existing poverty line. As Scott put it, “Our options are either having Floridians pay to fund this program in other states while denying health care to our citizens, or using federal funding to help some of the poorest in the state.”

Scott is just one of seven Republican governors who are now going to join in the expansion despite a recent U.S. Supreme Court ruling on the Affordable Care Act (ACA) that would allow states to opt out of the program.

Under the ACA, the federal government will pay for the entire cost of the Medicaid expansion for the first three years and then the states will contribute a small percentage after that. Fallin has said the added cost in the future—the exact amount is in dispute, but one estimate is only $28 to $37 million annually—is just too much for Oklahoma. Fallin argues it would cost the state an extra $689 million from 2013 to 2022.

The real question, of course, is whether Fallin’s decision was based on political expediency more than personal commitment. All signs indicate she will run for reelection and anything associated with President Barack Obama is politically toxic for Republicans in Oklahoma. On the other hand, Fallin’s recent state of the state address stressed issues that would improve the overall health of the state’s residents, including an effort to reduce the smoking rate here. Is she compensating for her morally unjust decision to deny health insurance to a potential 180,000 low-income Oklahomans?

Let’s be clear: Expanding Medicaid would make a dramatic impact in the state’s overall health outcomes.

Fallin’s plans to reduce smoking rates and increase budget funding for mental health issues are admirable, but they pale in comparison to allowing better access to health care for thousands of people. The legislature has already killed Fallin’s idea to allow cities and towns to ban smoking in public spaces. Now let’s see if the Department of Mental Health and Substance Abuse Services even gets the extra $16 million Fallin proposed in her state of the state speech.

Of course, Oklahoma is no Florida, which gave Obama its majority of votes last November in the presidential election. By accepting the Medicaid expansion, Fallin could give a potential Republican political opponent leverage in the 2014 election.

In addition, the state’s largest newspaper, The Oklahoman, has a fanatical obsession with criticizing so-called Obamacare. A recent editorial fantasized about a doomsday scenario in which new Medicaid recipients couldn’t find a doctor to treat them. Of course, those new people who would qualify for Medicaid probably can’t find a doctor to treat them NOW unless they go to an emergency room.

So what is Fallin to do? The fact the other Republican governors are accepting the expansion absolutely does give Fallin cover to make the courageous decision. Is there any Republican with the same name recognition and overall popularity as Fallin who could seriously challenge her in the gubernatorial primary election in 2014? If she made the decision now to accept the expansion, it would be long forgotten by election season anyway, lost in the state’s collective memory hole. The Oklahoman, now owned by a Colorado billionaire, just doesn’t matter as much anymore within the diversity of the digital media world.

Fallin, 58, might be too young to be overly concerned with her legacy, but her current refusal to accept the Medicaid expansion is a historic error. If she reversed course, she would secure a long-lasting reputation not only as the state’s first female governor but as a compassionate conservative, who made a difficult political decision to provide easier access to health care for thousands of people in a state with a dismal history of poor overall medical rankings.