With a vote on a state question to expand Medicaid less than three weeks away, Republican state lawmakers think they know how it will go.
"I think 802 is likely to pass," House Majority Floor Leader Jon Echols (R-Oklahoma City) said during a legislative briefing with the Tulsa Regional Chamber.
"We’re all expecting it to pass. We are," said Senate Majority Floor Leader Kim David (R-Porter).
Echols and David said the challenge is figuring out how to pay for expansion under State Question 802, which would amend the state constitution to make thousands of adults eligible for coverage. The state must pay 10% of the cost, with the federal government covering 90%.
"Conservatively, everybody says it will be about $170 million. I think it’ll be closer to $300 million, possibly a little more," David said.
Before the pandemic and recession, the Urban Institute estimated Oklahoma’s share of expansion would be $117 million. Policy groups estimate Oklahoma's share could be as much as $200 million.
David hopes voters will approve an initiative from the legislature later this year to use tobacco settlement funds for Medicaid expansion, but that would cover only about $56 million.
Echols said a plan to increase a fee on some hospitals passed by the legislature but vetoed by the governor as he withdrew his expansion proposal won’t make a comeback. Echols said he’d "be shocked" if provider reimbursement rates are not cut as part of a funding plan.
"I’d be shocked, because it’s a question of math. Where is it going to come from? The other reality is, or we’re going to take it out of the general budget. The general budget is 50% education, one-third common education. You can’t cut teacher salaries. We’re losing too many to begin with," Echols said.
SQ802 is on the June 30 ballot. Lawmakers would have a year to put funding in place.