O-K-L-A-H-O-M-A OK

Math has a well known liberal bias.

 

That is the Oklahoma House passing a Medicaid expansion bill.

The state is heavily dependent on cyclical resource extraction taxes (oil and gas) for a significant chunk of their state budget. The state is facing a a massive deficit and Expansion is a good way to solve a decent chunk of the problem while not destroying the public health system:

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 Obama’s new health care system.

What’s more, GOP leaders are considering a tax hike to cover the state’s share of the costs.

“We’re to the point where the provider rates are going to be cut so much that providers won’t be able to survive, particularly the nursing homes,” said Republican state Rep. Doug Cox, referring to possible cuts in state funds for indigent care that could cause some hospitals and nursing homes to close.

The law still needs to go through the Senate and get signed by the Republican governor. After that the state will need to negotiate with the Center for Medicare and Medicaid Services for a waiver as Oklahoma wants to adapt the Arkansas model. Arkansas buys private exchange plans and then tops up their cost sharing assistance for people to minimize the deductible.

From a cash flow perspective this is interesting. Private exchange plans tend to pay providers significantly higher rates than Medicaid. It allows Oklahoma to send their rural providers a decent income stream that should allow the state to hold steady or even decrease their Legacy Medicaid provider rates. That is one source of state cash savings. The other is it moves a lot of people from Legacy Medicaid with a high state share to Expansion Medicaid with a low state share of the costs.

Over the long run, state budget math has an expansionary bias. Expansion solves several big problems without allowing too many hard choices to be made (as well as make the residents of the state better off). It is a one way ratchet. This is why national Democrats have been proposing to give every state three years of 100% funding, and I wish that they would propose bumping up Legacy Medicaid federal shares by several points contingent on expansion being in place. Those policies are big bribes to get the hold-out states on board because sooner or later every state budget will need some relief. Federal Medicaid money is relief.






70 replies
  1. 1
    Cermet says:

    Again, our President’s signature achievement saves lives, improves those same lives, and even gets thugs off the hook relative to tax increases (some.) Thanks President Obama – your the Man! (Soon to be replace by “The Woman”)

  2. 2
    Baud says:

    @Cermet:

    IMPEACH!

  3. 3
    OzarkHillbilly says:

    Oklahoma is still not OK.

  4. 4

    @OzarkHillbilly: Okay, so it may be slightly better than twice warmed over coffee that has been sitting for three days on the counter but that is an improvement

    Baby steps here… baby steps

  5. 5
    Tokyokie says:

    Speaking from experience, Oklahoma is one of those places whose capable residents leave. Even it its state song is a Broadway show-tune classic.

  6. 6
    NorthLeft12 says:

    THANKS OBAMA!

    I think it is horrible how Obama is tyrannically using his powers [that he really doesn’t have] to destroy the constitution and the American way of life and force these states to make life better for their citizens…..said every Right Wing Nut Job ever.

  7. 7
    Betty Cracker says:

    I wonder what will it take to get Florida to stop punching itself in the dick? It’ll probably be 1) an economic downturn / oil spill that tanks tourism, or 2) a non-alien lizard life form assuming the governorship combined with the loss of the wingnut supermajority in the state house. My bet is on door number one…

  8. 8
    Punchy says:

    I love that “conservative groups” are opposing this because 1) nobody conservative has ever had an elderly parent in a nursing home and 2) because its the compassionate, conservative viewpoint to want to shutter nursing homes and throw the occupants into the street.

    Nice ideology ya got there, assholes.

  9. 9
    Davebo says:

    @Betty Cracker:

    Gulf Coast states milked the BP settlement for all it’s worth but I’d imagine due to it’s size Florida’s cut was quite diluted.

    I wouldn’t count on an oil spill. At today’s prices offshore just isn’t profitable like it was.

    Work on evicting the alien life form!

  10. 10
    Patricia Kayden says:

    When Kansas follows Oklahoma’s lead, we’ll know that Republicans have thrown in the proverbial towel. I would love to hear how opposing the ACA fits into WWJD in the alternate universe inhabited by Conservatives.

    Good for OK.

  11. 11
    rikyrah says:

    But but but
    That evil Federal money
    Uh huh
    Uh huh

  12. 12
    amk says:

    Wait till prezzie trump repeals obamacare kenyankare on day one, hour one.

  13. 13
    lollipopguild says:

    Meanwhile we can continue to work on dragging the GOP kicking and screaming into the 20th century.

  14. 14
    Glidwrith says:

    What I love is how they are talking about the providers going out of business as one of the main drivers; nary a mention of all the folks suffering from untreated medical conditions.

    Definitely not OK, Oklahoma.

  15. 15
    Central Planning says:

    Oklahoma! was the first musical I was in at the young, tender age of 14. Summer theatre was a blast.

    And to be a curmudgeon – nobody fucking cares that your kid “graduated” from pre-k. WTF are you doing buying a cap and gown for them? Jesus H. tap-dancing Christ.

  16. 16
    Baud says:

    @Central Planning: I’d hate to be the kid who didn’t graduate from pre-K.

  17. 17
    low-tech cyclist says:

    @lollipopguild:

    Meanwhile we can continue to work on dragging the GOP kicking and screaming into the 20th century.

    That’s easy! They love the 1950s, when America was berry, berry good to white males, but a woman’s place was in the kitchen, and Negroes knew their place.

    Trying to drag them into more recent decades is the challenge.

  18. 18
    Davebo says:

    @lollipopguild: Let’s go all out and shoot for the 21st century.

    The 20th is where they are now firmly ensconced in 1952.

  19. 19
    Central Planning says:

    @Baud: It’s just a kindergarten mill. You pass pre-k! You pass pre-k! Everyone passes pre-k!

  20. 20
    OzarkHillbilly says:

    @Richard Mayhew: You forgot ‘with the mold floating on top’.

  21. 21
    rikyrah says:

    @low-tech cyclist:

    That’s easy! They love the 1950s, when America was berry, berry good to white males, but a woman’s place was in the kitchen, and Negroes knew their place

    tell that truth.

  22. 22
    OzarkHillbilly says:

    @Baud: I didn’t. Oh wait a minute, we didn’t have pre-K.

  23. 23
    Mai.naem.mobile says:

    I thoughtJayzuz didnt let red state residents get sick. What happened?

  24. 24
    yellowdog says:

    @low-tech cyclist: The thing is that you have to be over 65 to even remember the Fifties. These people have nostalgia for what they’ve never experienced. Or it is just pure and simple racism and misogyny. No era has a claim on those sterling virtues.

  25. 25

    @Betty Cracker:

    I wonder what will it take to get Florida to stop punching itself in the dick?

    A way for Governor Voldemort to profit personally from expansion.

  26. 26
    MomSense says:

    @Glidwrith:

    What I love is how they are talking about the providers going out of business as one of the main drivers; nary a mention of all the folks suffering from untreated medical conditions.

    Some “culture of life” the Republicans have.

  27. 27
    Betty Cracker says:

    @Roger Moore: Voldy explored that dodge already, using his own mother’s death for political cover. (I am not making this up.) It didn’t work.

  28. 28
    MomSense says:

    @low-tech cyclist:

    Yup. Funny how they never say a word about how high taxes were then in those good ole days.

  29. 29
    OzarkHillbilly says:

    @Mai.naem.mobile: Faith healers will soon be demanding payment from Medicaid and Medicare.

  30. 30
    Face says:

    I thought Republicans were anti-tax? What’s the percent increase when one tacks on $1.50 to a pack of cancer sticks? 30%? 50% This tax is crazy huge. I’d like to think savvy Dem challengers would make light of this.

  31. 31
    RaflW says:

    Unfortunately a friend who lives in OKC posted last night that the state is going to slash education funding as part of the budget crisis. She says that many smaller school districts will go to 4 day per week school, which places huge strains on working families.

    So it isn’t all OK in OK, not surprisingly. Hopefully they won’t swirl the drain quite as badly as neighboring KS with their fantastic Brownback making things exponentially worse than they need to be.

  32. 32
    Steve in the ATL says:

    @Central Planning:

    And to be a curmudgeon – nobody fucking cares that your kid “graduated” from pre-k. WTF are you doing buying a cap and gown for them? Jesus H. tap-dancing Christ.

    Ed from Gin and Tacos said something like “Get off the stage, kid–you ain’t accomplish shit yet!”

  33. 33
    NorthLeft12 says:

    @yellowdog:

    The thing is that you have to be over 65 to even remember the Fifties.

    Except the younger RWNJs know what the fifties were like from the TV and what their parents and grandparents told them about it. Darker hued people were not part of that narrative, and the immigrants back then were nicer, whiter, and fewer.

  34. 34
    J R in WV says:

    @OzarkHillbilly:

    They’re already approved and receiving payments if they call themselves Christian Scientists.

    Sorry…

  35. 35
    OzarkHillbilly says:

    @J R in WV: Damn. Art, or at least a joke, imitates life again.

  36. 36
    jeff says:

    RINOs everywhere.

  37. 37
    dr. bloor says:

    @Glidwrith: I’ll take a good outcome stemming from a misguided motive every day of the week and twice on Sundays. “You might lose your doctor” is always going to be more effective with the Haves than “let’s address the needs of the Have Nots.”

  38. 38
    Face says:

    which places huge strains on working families

    This goes without saying, but families who overwhelmingly vote Republican in every election, because who needs schools as long as f#gs cant get wedding cakes and every clinically insane person is nonetheless allowed to own 17 firearms?

    Elections, consequences. Dear OK (and KS, MS, etc) — STFU until you act accordingly.

  39. 39
    Mike in NC says:

    Spent a night in a motel outside OKC more than 30 years ago, yet still vividly remember the overpowering stench of cow manure and the noise of the drunks fighting in the parking lot. Got out of there at first light and would never go back.

  40. 40

    @Punchy:
    2 is absolutely true, but many do have elderly nursing home relatives. They can simultaneously vote to throw those relatives out on the street and blame us. It’s actually easier than accepting responsibility.

    @Patricia Kayden:
    …you know, I consider myself an expert on conservative thought, but I can’t answer this one. I can tell you rock solid for sure that they do have an answer, and most can quote a bible verse or two to back it up. Selective reading to turn a man of peace into a justification for hate is the cornerstone of their religion.

    @NorthLeft12:
    This 1950s ideal fascinates me, because not only is it an imaginary 1950s, they treat it as the beginning of time. Most ‘traditional family values’ were less traditional in the 30s and 40s than today.

  41. 41
    Matt McIrvin says:

    @NorthLeft12: The Fifties were best when they were the subject of nostalgia in the Seventies and Eighties. That’s the Fifties I remember: the one that never actually happened, but Fonzie said “Ayyyy!” a lot. I’m even a bit nostalgic for the nostalgia!

  42. 42
    OzarkHillbilly says:

    @Mike in NC: Well, as long as they stay in the parking lot, what’s the problem?

  43. 43

    @NorthLeft12: Reality never bothers wingtards. In India, the ideal time is not the 1950s but 5000 years ago. Since no one who is alive now was alive then, then make up whatever the want about this so-called “ideal” time.

  44. 44
    Matt McIrvin says:

    …but for some reason it wasn’t until the early 21st century that I remember liberals turning Fifties nostalgia back on conservatives, and pointing out that it was a time when the highest marginal tax rates were enormous, government spent huge sums on national infrastructure, there were regulations on business and industry that would be unimaginable today, economic inequality was relatively low (if you were white, granted) and unions were stronger than they are now.

  45. 45
    Chris says:

    @Betty Cracker:

    I wonder too. You’re entirely correct about Florida being a great microcosm of the U.S: unfortunately, that comes with all the bad as well as the good.

  46. 46

    @Matt McIrvin:
    It took about twenty years for the rot inside the Reagan Revolution to start eating at the mask, yes. It was about a lie sold to all of white America more than specific policies.

  47. 47
    Chris says:

    @Patricia Kayden:

    I would love to hear how opposing the ACA fits into WWJD in the alternate universe inhabited by Conservatives.

    They think charity is wonderful but government assistance is bad, because charity comes from the heart and government assistance is the government robbing Peter to pay Paul. Jesus wants the former but not the latter, oh no sir, perish the thought.

  48. 48
    Matt McIrvin says:

    @Frankensteinbeck: Their economic ideal isn’t the 1950s at all, it’s the 1890s.

  49. 49

    @Matt McIrvin:
    I think a big part of that is that you’re misreading the subtext of the Democratic message. It isn’t really about high taxes, infrastructure spending, and union membership; it’s about the 50s not being the fantastic time the Republicans make them out to be. When the party was still dominated by straight white men, the Democrats had the same kind of 50s nostalgia the Republicans did and didn’t want to badmouth the time. It’s only as the party has become more diverse and increasingly run by the kinds of people who had it bad in the 1950s that the Democrats have been willing to point out the downsides of the 50s.

  50. 50

    @Matt McIrvin:

    Their economic ideal isn’t the 1950s at all, it’s the 1890s 1850s.

    FTFY.

  51. 51

    @Chris: Charity is wonderful because they can pick and choose the “deserving poor”.

  52. 52
    Luthe says:

    @Matt McIrvin: There are waves of nostalgia that run through American society on roughly 20-year cycles, pegged to whenever the latest generation gets enough disposable income to relive their childhoods through media/fashion/toys/trends etc. So you have Grease and Happy Days being big in the 70s and bellbottoms coming back in the 90s (and possibly returning nowish). Enduring 50s nostalgia is just a subsection of Silents/Boomers who refuse to let go (and passed it on to their GenX kids).

  53. 53
    EBT says:

    @Face: Just drive to the reservation and buy 99 cent packs. When I lived across the river in Arkansas that trip was made a few times.

  54. 54
    sylvainsylvain says:

    @EBT:

    They’ve tightened that up in recent years, after the interstate compact/tobacco settlement/whatever they call it.

    There have been several lawsuits over it. Indian run smoke shops aren’t a good deal for smokes anymore.

    It’ll be interesting to see the unintended consequences of an additional $1.50/pack tax on cigarettes. More vaping? More interstate smuggling? Okies smoke more than most.

  55. 55
    EBT says:

    I quit when old style Djarum cloves were taken off the market in protest, but I would imagine smuggling vape cartridges will be the new thing. I can attest from the cannabis ones that you can suck a cart down much faster than intended.

  56. 56
    Chris says:

    @Matt McIrvin:

    The Fifties were best when they were the subject of nostalgia in the Seventies and Eighties. That’s the Fifties I remember: the one that never actually happened, but Fonzie said “Ayyyy!” a lot. I’m even a bit nostalgic for the nostalgia!

    This. Because “nostalgia” is so often a product of pop culture and hazy collective memory, it’s not necessary to have actually been there. I “get” the eighties nostalgia that pop culture’s been crazy about more recently, for example, because a whole bunch of my childhood entertainment came from that era… but that’s not to say that I actually saw any of it in theaters or remember when it came out; Star Wars and Indiana Jones were at least ten years old by the time I saw them.

    Apparently, something like that applies when “remembering” politics, too.

  57. 57
    lollipopguild says:

    @Matt McIrvin: I think it is actually the 1850’s because slavery would be legal again.

  58. 58
    lollipopguild says:

    @Roger Moore: Do you have a device that reads minds?

  59. 59
    Chris says:

    @Matt McIrvin:

    Depends what you mean by “they.” I think the 1950s is the ideal for many, possibly most conservative voters – the peace and prosperity are a huge part of the appeal, after all. They just have zero idea what economics made that era possible. They want to get the benefits of an economically liberal society, without any of the liberal policies or liberal politicians that you need in order to have these things, and don’t understand why they can’t because they can’t even understand that what they’re nostalgic for is a liberal economic order.

    The super-wealthy and even more the politics nerds may miss the 1890s, but that’s not what they say in public.

  60. 60
    Prescott Cactus says:

    @ Richard Mayhew – OP

    The state is heavily dependent on cyclical resource extraction taxes (oil and gas) for a significant chunk of their state budget.

    I got stuck in Tulsa for 3 days because of a snow storm. Had to leave because another was coming not that the roads were clear. Snow is not unexpected in Northern OK, they just don’t want to invest in needed equipment.

    Oklahoma’s unwritten Highway Snow Removal Plan is: Keep both plows gassed up and hope for two sunny days with 60 degree weather.

  61. 61
    Prescott Cactus says:

    @lollipopguild: My wife does. 95%+ accuracy rate. I’d love to find it.

  62. 62
    lollipopguild says:

    @Prescott Cactus: Almost everytime I go to put a comment in a thread i discover that Rodger has beaten me to it.

  63. 63
    Prescott Cactus says:

    Twins separated at birth or a slower internet provider ?

  64. 64
    lollipopguild says:

    @Prescott Cactus: Great Minds think alike but Rodger types faster.

  65. 65
    NorthLeft12 says:

    @Chris: Pretty funny about that “peace” part. Korean War, various military actions in Puerto Rico, Laos, Vietnam, surprisingly I did not see anything in Central America. But, it was very peaceful, right?

  66. 66
    Miss Bianca says:

    @lollipopguild: Roger beats a heck of a lot of us when it comes to posting the great insights.

  67. 67
    sunny raines says:

    just another healthy dose of Blue states subsidizing piss-ant red states and the steaming piles of human excrement they elect to lead them, aka republicans.

  68. 68
    lollipopguild says:

    @sunny raines: I think you are trying too hard to be subtle.

  69. 69
    Matt McIrvin says:

    @Chris: There is genuine Gilded Age nostalgia among libertarians; has been for a long time. (I keep remembering Robert Heinlein’s Future History time chart, and the way he had “restoration of nineteenth-century economy” as the thing that got the US back on an even keel after a series of crises.)

  70. 70
    Matt McIrvin says:

    Also, I get the impression that the 1950s of the 1950s was the period around 1910-1914: the early childhood years of middle-aged people of the time, just before the World Wars. (Think Main Street, USA at the Disney parks: that was Walt Disney’s personal happy time.)

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