Despite bitter resistance in Oklahoma for years to President Barack Obama's health care overhaul, Republican leaders in this conservative state are now confronting something that alarms them even more: a huge $1.3 billion hole in the budget that threatens to do widespread damage to the state's health care system. So, in what would be the grandest about-face among rightward leaning states, Oklahoma is now moving toward a plan to expand its Medicaid program to bring in billions of federal dollars from President Obama's new health care system.
In recent years, as the Affordable Care Act has taken root, there are a series of great anecdotes about Americans who thought they hated the reform law, right up until they really needed it. At that point, these consumers tended to effectively say, "Maybe blind hatred for Obamacare wasn't such a good idea after all."
As it turns out, a similar situation has unfolded in many state capitols, where Republican policymakers are certain they want to reject every possible aspect of the ACA, until it dawns on them this posture ends up hurting their state for no reason. The Associated Press turned the spotlight on Oklahoma today:
This shift has been predicted for years, though it's taking longer than health care advocates had hoped. Just how long can a state like Oklahoma spite itself, on purpose, because it doesn't like the president? What would it take for officials in the Sooner State to succumb to arithmetic?
In this case, Oklahoma's big budget shortfall, and the prospect of closing state-subsidized nursing homes, was enough to start changing Republicans' minds.
Craig Jones, the president of the Oklahoma Hospital Association, told the AP, "We are nearing a colossal collapse of our health care system in Oklahoma. We have doctors turning away patients. We have people with mental illnesses who are going without treatment. Hospitals are closing, and this is only going to get worse this summer if the Legislature does not act immediately to turn this around."
Warnings like these appear to have raised eyebrows, even among far-right policymakers.
The AP report added, "Despite furious opposition by conservative groups, Republican Gov. Mary Fallin and some GOP legislative leaders are pushing the plan, and support appears to be growing in the overwhelmingly Republican Legislature."
The blueprint is still coming together, but Oklahoma will reportedly pursue a model based on Indiana's compromise with the Obama administration, which isn't quite as good as the Medicaid expansion policy as it was originally designed, but it will allow red states like Oklahoma to adopt the policy while saving face (and enjoying the much needed benefits).
Fallin has reportedly begun referring to the shift as "Medicaid rebalancing," as a way to avoid references to the president's name.
For those keeping score, 31 states have adopted Medicaid expansion through the ACA, and Oklahoma would be the 32nd if the state proceeds on its current course. South Dakota, Wyoming, Alabama, and Idaho are among the remaining holdouts eyeing a similar change in direction.