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Medicaid expansion ballot initiative
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Attorneys with Crowe & Dunlevy today filed a Medicaid expansion ballot initiative Friday on behalf of two Oklahomans, one from Tulsa and one from Oklahoma City.

Oklahoma Secretary of State Michael Rogers’ office posted the seven-page filing (embedded below) online and distinguished it as State Question 802. The ballot initiative would make a change to the Oklahoma Constitution, thus requiring 177,958 signatures for it to make the ballot. Signature collection would extend for 90 days after any challenges have been resolved or addressed.

The current proposed ballot language would read:

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.

Legislature discussing own plan

Republican leaders of the Oklahoma Legislature have been discussing their own version of a Medicaid expansion plan, one that would likely expand the existing Insure Oklahoma program that provides public subsidies for private insurance plans.

“We’ve heard rumors for a while that that might be filed. I’ll be interested to see more details and know more about who is behind the measure,” said Sen. Greg McCortney (R-Ada) on Friday. “This is part of a democracy. The people get a chance to vote for measures like this.”

McCortney ran a bill pushing an “Oklahoma Plan” for Medicaid expansion earlier in the session, but it stalled. Lawmakers have continued to meet on the issue, however.

“I have not stopped talking about it all session, and I continue to be hopeful that the Legislature will deal with this before we get out in May,” he said. “I think the Legislature is definitely the proper place for something like this to be dealt with. I think the petition is probably out of frustration that the Legislature hasn’t done something yet.”

Thursday, House Minority Leader Emily Virgin (D-Norman) offered a similar perspective.

“I think it’s our job to get this done as the Legislature,” Virgin said. “We were elected to make these types of decisions, and it’s just silly that the people would have to take it into their hands and go through the ballot initiative process.”

But Jonathan Small, president of the Oklahoma Council for Public Affairs, said earlier in the week that groups will oppose any Medicaid expansion ballot initiative in the Sooner State.

“What’s important to notice about other states that have expanded Medicaid is that in every case they have wildly underestimated enrollment and costs,” Small said. “There’s been roughly 12 million enroll in Medicaid, and we thought there would be about 6 million.”

Small said groups would also be working to convince lawmakers not to pursue their own version of Medicaid expansion as well.

David Blatt, executive director of the Oklahoma Policy Institute, also spoke about the topic earlier this week, saying plenty of groups will counter the opposition of OCPA.

“I think that there is strong support for Medicaid expansion in the population at large, and if the Legislature can’t get it done, I think there is every chance of an initiative petition succeeding in gathering signatures and making it onto the ballot,” Blatt said. “What we saw last year in other conservative states is that, if voters are given a chance to decide, they will support expanding coverage.”

U.S. Congressman Tom Cole (R-OK4) was also at the Capitol this week. Asked about a potential Medicaid ballot initiative, he said it’s certainly an option and that he tries to stay out of state issues. But he did discuss the question legislators will face if a ballot initiative were filed.

“I think you’d want to not just take a straight ACA approach. i think you’d want to do some reforms and see what kind of waivers you can get from the federal government,” Cole said. “You’d get a very friendly administration, probably, in that regard. And see what you can do to make sure you don’t get trapped in a situation that this explodes on you. Like the governor, I’m skeptical that we will have a 90/10 division indefinitely. It’s a 63 percent federal program and 37 percent state on average.”

McCortney said the fact the ballot initiative filed Friday would put the issue into the Oklahoma Constitution “causes me a little concern.”

“Putting it in the Constitution, in my mind, would pose some challenges,” he said. “If the federal government changes the program, I don’t know that we’d have the flexibility to make changes.”

Read the filed language of SQ 802

(Update: This story was updated at 5:27 p.m. Friday, April 19, to include additional quotes.)