2018 MIDTERM ELECTION

Time: D H M S

Oklahoma: The very definition of irony.

The conventional wisdom when it comes to taxes is that Republicans are always for cutting 'em while Democrats are always for raising 'em. The reality, of course, can be far more complicated--it's not just about cutting or raising taxes, it's also about who's getting the increase/decrease and what the money would/no longer would be used for. Even so, this is an odd-sounding story at first glance.

Just last week, the Big News Shocker out of Oklahoma was the blood-red Republican-controlled state legislature and governor were actually considering a) raising taxes (!!!) and b) expanding Medicaid via the ACA (!!!) in order to dig themselves out of their self-dug financial hole:

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.

Today, however, Louise Norris of healthinsurance.org reports that the OK GOP tried to play Lucy with the football...but the Democrats in the state house decided not to take the bait after all:

The money collected by the cigarette tax would then be deposited into the state’s “Healthcare Revolving Fund” and could be used by state agencies that receive federal matching funds under the Social Security Act (eg, Medicaid). HB3210 was supported by Oklahoma Governor Mary Fallin.

The measure passed out of committee on May 17, but failed in a vote on the House floor on May 18. The final vote was 59 to 40, and the measure needed at least 76 Representatives in favor in order to pass. All of the yes votes came from Republicans, while the no votes included both Republicans and Democrats.

The deal-breaker for Democrats was that the measure did not specifically require the state to expand Medicaid. It would have essentially been a very regressive tax (tobacco use is much more common among lower-income residents), and the money in the Healthcare Revolving Fund would have been apportioned by lawmakers to agencies that get federal matching Medicaid funds – but there was no accompanying requirement that the state expand its eligibility guidelines for Medicaid.

...Oklahoma has not expanded Medicaid under the ACA. But it attempted to go one step further than that, and tighten already-stringent eligibility rules even more.

Amid a budget shortfall of $1.3 billion, lawmakers in the Oklahoma House of Representatives passed HB2665 in March 2016. HB2665 calls for eliminating Medicaid eligibility for non-pregnant, able-bodied adults under age 65. All 30 Democrats in the Oklahoma House opposed the bill, and were joined by four Republicans.

The "good" news is that this earlier bill (which I wrote about here) ended up failing, so about 111,000 poor people won't be kicked off of Medicaid after all (yet). The bad news is that Medicaid expansion won't go through in Oklahoma either.

To be honest, I have mixed feelings about this. It's true that, as noted by Norris, cigarette taxes are highly regressive since poor people are much more likely to smoke. On the other hand, cigarettes serve absolutely no useful function in society and are, of course, highly damaging in terms of public health for both the smoker as well as via second-hand smoke, fire risk and so on. Since this is all about improving the health of lower-income people, I'm not sure I have a whole lot of sympathy towards keeping the cost of a habit like smoking cigarettes low.

This is not the same as, say, the gasoline tax--yes, gas is bad for the environment, but at least it serves an obvious purpose for both the individual using it as well as society at large (at least until we switch everyone over to electric cars, that is).

Then again, it sounds like the bill in question really had nothing to do with expanding Medicaid at all; it was merely a way of replacing a bunch of tax revenue lost due to corporate tax cuts by shifting the revenue over to low-income people, so when you look at it that way, I completely understand the OK Dems crying foul. They're basically telling Fallin and the state GOP to put the coroporate taxes back the way they were in the first place instead of filling the budget hole on the backs of the poor.