Amazing. Oklahoma's ballot initiative to participate in Medicaid expansion just passed. It will bring health insurance coverage to nearly 200,000 state residents. A bright spot in dark times. pic.twitter.com/nkDvGRYo9L
— Vivek Murthy (@vivek_murthy) July 1, 2020
Oklahoma voters (or at least the narrow subslice that vote in mid-summer, mid-pandemic primary elections) approved Medicaid expansion last night. This will lead to 200,000 more people being insured once the system is ready to start enrolling people. The referendum was for a straight up state plan amendment expansion with a fairly rapid turn-around. There is no work requirements or angels dancing on the heads of a pin administrative burden built into the law. The newly eligible population can not be treated any differently than categorically eligible populations which will provide the newly eligible populations significant protection from future shenanigans.
Now what does this mean?
First, it means 200,000 more people will be insured. It means plenty of people are going to see their stress levels decrease. It will mean rural hospitals will have a lifeline. It will mean a large fire hose of federal money will be going into the state.
I am intested in the ACA markets. We have strong reason to know that Medicaid expansion lowers ACA gross premiums. I wrote the following when Virginia was debating Medicaid expansion:
First, more individuals with chronic conditions will have access to regular care — a factor we know helps reduce expensive visits to emergency rooms and high-cost hospitalizations. Evidence shows that individuals who earn between 100 percent and 138 percent of the federal poverty level (a family of four earning between $25,100 and $34,638) and currently buy ACA insurance have more chronic conditions and more expensive health care needs than individuals who earn over 138 percent FPL…
The second mechanism that could lead to premium reductions for the middle class is a little harder to follow, but is a result of President Donald Trump’s October 2017 termination of payments for cost-sharing reduction subsidies to insurers….
Virginia — like many other states — had its insurers load the cost of providing CSR into the premiums for silver plans, which are the plans that set the local benchmark from which all premium subsidies are calculated. This led to a significant spike in silver benchmark premiums. Other plans saw significant but far lower premium increases. On average, CSR workarounds led to an extra $960 to $1,040 in premiums for silver plans.
Depending on how fast the actuaries for Oklahoma ACA insurers act and how quickly they assume MEdicaid expansion will roll out and enroll the entire eligible population, we could anticipate a significant decrease in gross premiums for 2021 and a slight increase in net premiums for subsidized individuals.
On net, Medicaid expansion massively helps more people than it hurts in regards to obtaining and maintaining insurance coverage.
Missouri will vote on Medicaid Expansion in the first week of August.
Chief Oshkosh
Pssst! When do we get to tell them that they just voted to expand Obamacare?
David Anderson
WE DON’T
Just tell say that SoonerCare is awesome just like KyNect is awesome in Kentucky and then smile and wave boys, smile and wave
Cheryl Rofer
Saw a tweet along the lines of “People like having health care – who knew?”
hueyplong
Yes, on that rare occasion when their stupidity works for the general good, it’s best to let sleeping dogs lie.
It’s also a good time to note that the GOP taught us in 2004 that 50.5% is a mandate.
low-tech cyclist
When the voters have gotten the chance to vote directly on Medicaid expansion in a referendum, has there been any state that’s voted against it? I haven’t heard of any.
If Missouri votes for the expansion next month, the remaining non-Southeast states that haven’t adopted the expansion will all be pretty much surrounded by states that have. And then there’s that seven-state bloc of Southeastern states that haven’t. Funny how most of the remaining holdouts were part of the Confederate rebellion.
p.a.
By .5%… jeebus?
rikyrah
Yeah ????
Nicole
I’m so glad. Every state that expands access to health care makes it harder to take away later.
Jay C
@p.a.:
Not only was the OK Medicare initiative a squeaker, but I read somewhere that the actual implementation has to be approved by legislation.
Legislation from Oklahoma’s extremely-Republican-dominated Statehouse.
So I wouldn’t be out standing in line to sign up anywhere any time soon (if ever – I think (?)Nebraska also passed a Medicare-expansion initiative – still waiting on the Lege)
Mai naem mobile
I did not realize that there were still 13 states that hadn’t expanded Medicaid. I thought we were in the single digits . For some reason I thought NC, Wisconsin and Tennessed had expanded Medicaid because they had Dem governors.
Sab
@Chief Oshkosh: Let’s not.
Ocotillo
Yeah, I was thinking often when a state referendum goes the opposite way from what GOPers want, the state leg will step in and throw it out. Didn’t Florida do that with former felons getting to vote and Missouri on some sort of expanded voting rights?
Formerly disgruntled in Oregon
“OK OK”
Ohio Mom
In my mind’s eye, I see Obama with a big grin on his face at this news.
waspuppet
Wait — is that a thing in other states? I guess I shouldn’t be surprised, but I didn’t know.
jonas
@p.a.: With that narrow a margin of victory, I wonder how many people who voted against it will discover that they in fact now qualify for it?
Partly a rhetorical question, I guess. I recall listening to an interview a few months ago with a woman in North Carolina who had all sorts of health issues and no insurance. When the reporter told her she would qualify for close-to-free Obamacare insurance and could finally see a doctor, she said she would sooner die. Okay.
hells littlest angel
Tulsa asks, any chance of rolling this out in the next week or two?
jonas
@Ocotillo: I think in Utah, the legislature rolled back a Medicaid expansion that the voters had approved and by a considerably larger margin than in Oklahoma.
Another Scott
Just a reminder….
So much winning, we’ll be sick of it….
Cheers,
Scott.
WereBear
As the classic frog cartoon has it, “That’s not funny. That’s sick.”
Benno
@Chief Oshkosh: The 333,000+ who voted against it, very nearly half those who voted, already seem to know.
patrick II
49.52% of Oklahomans voted against allowing medical care for 200,000 fellow Oklahomans during a pandemic. I am glad it passed, but something is wrong.
WhatsMyNym
@Ocotillo: It’s an Amendment to the state Constitution, so hard to get rid of now. Though they will take their sweet time rolling it out.
JAM
Gov. Stitt is still making noises about “block grants” and other creative ways of keeping people from actually getting insurance, so we’ll see.
Another Scott
Relatedly, …
A big problem with the Recovery Act in the Great Recession was that it was too small, and too difficult to increase/extended it as the scale of the problem became fully known. Automatic stabilizers are essential because the accurate data always lags.
Cheers,
Scott.
opiejeanne
This is great news. I was wondering how the vote counting on this issue would turn out.
Helen
Nebraska passed Medicaid expansion by initiative vote in 2016. Governor Ricketts has delayed implementation until October 2020. Lots of excuses…
Oklahomo
I know some people who are very active in GOTV. In 2016, they started off for Bernie, then pushed for Hillary when she was nominated. They were very active in 2018, and are now doing GOTV for Biden. The insane part, they say, in GOTV for this, was countering all the bullshit about how “Pelosi and OAC would be choosing your doctors and treatments.” I’m still kind of shocked it passed; we are, after all, always sending dildos like Coburn and Inhofe to Washington.
Mai naem mobile
I hope if Biden wins a Biden admin uses a carrot and stick approach with a big stick to get the last 13 states to expand. Use the need for state assistance during this extraordinary period as leverage.
catclub
IN MY minds eye he is spitting in the general direction of the Roberts GOP court, that made the ACA changes in the medicaid law optional.
Applied to no other law that way.
catclub
@Another Scott: I do NOT understand why the GOP is going to wait until there is evidence of State budget collapse and mass firings before they approve more aid to the states. This will just in time to close schools due to no paid teachers.