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.
Despite bitter resistance in Oklahoma for years to President Barack Obama's health care overhaul, Republican leaders in this conservative state are now confronting something that alarms them even more: 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.
In a classic case of missing the forest for the trees, I posted two very wonky, detailed entries over the past couple of days about Minnesota and Connecticut's latest enrollment numbers...but completely missed one crucially important data point.
Just how grim the state’s budget situation has become was apparent Wednesday morning as the state House of Representatives discussed and ultimately agreed to a bill that would cut 111,000 Oklahomans, most of them women, from Medicaid.
Oklahoma is an example of how frustrating this rate review stuff can be, even when there's only a handful of companies involved and much of the data is easily accessible.
According to RateReview.Healthcare.Gov, Oklahoma only has a single company asking for rate hikes greater than 10%: Blue Cross Blue Shield of OK.
The main listing gives the requested rate increase as a jaw-dropping 43.95%...but the description below it says that "the range of rate increases by product is 22% to 34%".
Now, there are two additional BCBSOK listings on the Rate Review site which do appear to be included in the first one (all 3 list the total "members affected" as exactly 137,506)...but the other two have 22.64% and 33.83% listed as the "official" requested rate increase, both of which are still well below 44%.
How on earth you can have the individual product rate hikes range from 22-34% but average 43.95%, I have no idea. Obviously I'm missing something here.
At first, this article in the Washington Times doesn't look like anything special...it's basically one of dozens of stories about the potential political and real-world impact of the King v. Burwell decision on a specific state...in this case, Oklahoma:
OKLAHOMA CITY (AP) - While the U.S. Supreme Court considers a key case related to the Affordable Care Act, officials in Oklahoma have taken little action to prepare for a ruling that could threaten the tax subsidies nearly 90,000 residents are using to purchase health insurance.
HOWEVER, it's the next couple of paragraphs which made me do a double-take:
Because Oklahoma opted not to create a state exchange where residents could shop for health insurance, Oklahomans instead purchased their plans through a federal exchange, but opponents who are challenging the law, including Oklahoma Attorney General Scott Pruitt, argue the law only allowed for the subsidies through state exchanges.
A hospital group in cash-strapped Illinois says the state might be able to set up a health insurance exchange at a lower cost by "leasing" the federal government's technology, an option that could appeal to as many as 34 states where subsides could be jeopardized by an unfavorable U.S. Supreme Court decision.
A federal judge in Oklahoma ruled Tuesday that Obamacare subsidies provided on the federal HealthCare.gov exchange are invalid, agreeing with a ruling by a three-judge D.C. Circuit Court of Appeals panel against the subsidies.
The ruling, along with the fallout from the D.C. Circuit decision, could be a potentially significant defeat for the Obama administration.
On the one hand, this development probably makes it more likely that the SCOTUS will end up taking on the Halbig case (from the DC Circuit Court) after all (and/or the King case from the 4th Circuit...all three appear to focus on pretty much the same "federal exchange vs. state exchange" issue).
OK, I don't know what the requested rate changes for 2015 were in Oklahoma, but this appears to be the final word:
Health Insurers Submit Exchange Rates for 2015
OKLAHOMA CITY –Oklahomans shopping for individual health insurance policies through the federal exchange will be able to choose from six different companies offering multiple plans. Rate renewals for 2015 policies range from a decrease of 9.1 percent to an increase of 29 percent. The actual rate for an individual will depend on several factors, including age, geographical location and tobacco use.
“In the second year of the federal exchange, carriers have adjusted their rates to adequately reflect their utilization costs, comply with federal rules on medical loss ratios and reflect revisions to their provider networks,” said Oklahoma Insurance Commissioner John D. Doak.
