- Associated Press - Tuesday, April 5, 2016

Here are excerpts from recent editorials in Oklahoma newspapers:

The Oklahoman, April 4, 2016

Expansion of Medicaid not a budget cure-all for Oklahoma

The news that Oklahoma’s Medicaid program may cut provider rates by 25 percent due to the state budget shortfall will undoubtedly lead some critics to insist this would not be happening had Oklahoma expanded Medicaid under the Affordable Care Act.

Yet while the state would have received additional federal funds for Medicaid under Obamacare expansion, that money would have been used for new enrollees, not those currently in the program. The program would still face cuts this year and provider-rate reductions would likely still be on the table.

Supporters of expansion often ignore that adding people to the program also increases costs that state government struggles to cover in a time of budget challenge. Making a struggling program bigger isn’t the same as making it stronger, and expansion could actually amplify state government’s financial challenges.

Medicaid as it currently exists in Oklahoma primarily serves the very low income, mostly children and pregnant women. Under expansion, thousands of able-bodied adults with incomes above the poverty line would be added to the program.

Oklahoma currently must provide around $4 in state funding for every $6 in federal Medicaid spending on current enrollees (the aforementioned women and children). Under the Affordable Care Act, the federal government pays 100 percent of the extra costs for the expansion population through 2016, then 95 percent before leveling off at 90 percent in 2020 and afterward.

But even with expansion, Oklahoma would still have to provide the roughly 40 percent match for the existing Medicaid population, so that budget challenge would remain the same.

Those who say the health care system will be strengthened by expanding Medicaid basically imply that providers will make enough off the expansion population to subsidize treatment of the core population of existing Medicaid enrollees. That’s debatable.

One criticism of Medicaid is that it pays less to providers than the cost of treatment. Presently, Medicaid pays physicians about 87 percent of what Medicare pays, and Medicare pays less than most private insurance. If provider rates are cut another 25 percent, the rate will fall to just 64.9 percent of Medicare rates. But under either scenario, Medicaid payments are so low that doctors treating those patients can struggle to stay profitable. Adding more people to an underpaying program will not significantly alter that equation.

Also, the state match required for Medicaid expansion is not insubstantial. A Leavitt Partners report in 2013 predicted Oklahoma taxpayers would fork over $850 million over 10 years for Medicaid expansion. That may have been a lowball figure, based on the experience of other states.

Before Medicaid was expanded in Ohio, officials predicted 366,000 people would be added to the program. After expansion, the actual increase was more than 600,000. Officials predicted the cost of Ohio’s Medicaid expansion would be $2.56 billion for the first 18 months of Medicaid expansion. The actual cost was nearly $4 billion.

If a similar scenario occurred in Oklahoma, the state share of Medicaid expansion costs could run closer to $1.3 billion over a decade. Such concerns are one reason why state officials have balked at embracing Medicaid expansion. Imagine how dire this year’s $1.3 billion budget shortfall would be if lawmakers were also grappling with Medicaid costs and enrollment that were skyrocketing far above current trends.

Whatever else may be claimed about Medicaid expansion, it’s no cure-all for state government’s fiscal challenges.


Stillwater NewsPress, March 30, 2016

Time to take some action

We should be just about finished with the talking stages of earthquake prevention and response. Hopefully, we can consider these the planning stages, or the beginnings of the action stages?

The manmade earthquake deniers have all been written off since we had our January earthquake “swarm” that correlated to injection wells coming back online after a power outage. Now, Tuesday’s map by the United States Geological Survey that pointed to potential hazardous locations for natural and manmade earthquakes, we have a solid sense of government cooperation.

If you haven’t seen it, the forecast area paints a huge glob across central Oklahoma from north Texas to southern Kansas. Most of the state lives in these areas, but the ball didn’t really get rolling until Edmond was rattled and it shook more state leaders awake.

Now, it isn’t that we have more proof, but we do have reactions that let us know we haven’t been screaming into a void. Messages from Gov. Mary Fallin and the Oklahoma Corporation Commission in response to Tuesday’s map were mostly self-congratulating about the reduction of wastewater disposal operations, like “See, we told you it was working.” The 4.2 just after midnight Tuesday probably didn’t help, but yes, kudos, slowing down the thing that is causing the earthquakes is slowing down earthquakes.

For obvious reasons, government agencies and politicians were slow to blame the oil and gas industry for earthquakes. The blame game is over. Research into the cause of quakes should be over.

Now is the time for alternatives. We need to do something else with produced water other than shooting it into the ground. We need to be educated on what to do in response to a catastrophic earthquake. We need job- and tax-producing industry that doesn’t rely solely on oil and gas. We can’t sit around waiting for the next boom.

These are not pie-in-the-sky pipe dreams. Energy alternatives may soon be very necessary. Consider what would happen to coal-fired power plants if the Clean Power Plan, currently under a stay from the Supreme Court, moves ahead? Maybe some can keep up with the new regulations. Maybe some can’t. It’s best to be prepared.


Tulsa World, April 1, 2016

Don’t penalize schoolkids for the bureaucrats’ mistake

Nearly 50 Oklahoma school districts are suing the state in an effort to make good 22 years of miscalculated revenue.

They deserve their money.

But they have asked the Oklahoma Supreme Court to claw the money back from other school districts that - through no misdeed of their own - were given that money over the years.

That would compound a mistake with a miscarriage of justice.

In 1990, the Legislature changed the way some property tax revenue was to be distributed by the state. The new distribution method was supposed to go into effect in 1992, but the Oklahoma Tax Commission and the Oklahoma Department of Education somehow didn’t get the message until 2014.

Decades of miscalculation could total as much as $300 million, and it’s hard to argue that the school children of the districts that got shortchanged shouldn’t get the benefit of that money.

But the lawsuit filed by the aggrieved districts calls for the money to be taken back from the districts who were overpaid, thus penalizing future school children for the mistakes of the Oklahoma City bureaucrats, a gross injustice.

The lawsuit cites statutes that would back up the claw-back plan, but it seems obvious to us that this is an extraordinary circumstance that should lead in a different direction. In a period when the state is already reneging on its education budget commitments to every school district in the state and moving toward a budget that promises even more funding erosion, school districts that did nothing wrong should not be held accountable for the state’s mistake.

This is a one-time expense for the Legislature to work out and distribute accurately. Hold the benefiting districts harmless. Reimburse the districts that didn’t get what was coming to them. And find out what’s up at the tax commission and the Department of Education and make sure it never happens again.

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