Weekly Opinion/Editorial

CHICKEN FRIED INSURANCE TAX!
by Steve Fair

Back in 1992, Oklahoma passed State Question #640. The measure prevents the legislature from raising taxes without approval from the voters, or three fourths of each house of the legislature. Last week, the Oklahoma State Supreme Court ruled a proposed one percent fee on health insurance claims (HB 2437) was unconstitutional. Six of the nine justices said it violated the constitutional provision that SQ 640 established.
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The ruling presents a challenge for state government on how Medicaid will be funded in the state. The new ‘fee or tax’ was expected to generate $78 million and create a dedicated funding source for Medicaid. The fee was to take effect last Friday. Many business interests opposed the bill because they knew the fee would be passed onto them in price increases, which they would have to pass on to their customers.
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The day the Supreme Court made the ruling, a local GOP elected official held a fundraiser. The keynote speaker for this particular fundraiser was Oklahoma State House of Representatives Speaker Designate Kris Steele, (R-Shawnee).
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After the normal ‘mutual admiration society’ ritual you see at fundraisers, Steele spoke about what the 2011 legislature will face, including budget challenges. After he spoke, he took questions from the attendees. A local Duncan physician stated, “You need to talk more about health care in Oklahoma.” An increasing large amount of health care in Oklahoma is being funded via Medicare or Medicaid, “ the doc said. A local attorney asked, “What’s the back-up plan for Oklahoma after this ruling today?” Excellent questions normally not asked at political fundraisers.
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Steele wasn’t rattled by the questions and expertly outlined a number of things the legislature has done in the past few years to enhance health care in Oklahoma. Steele and Representative Doug Cox, (R-Grove), co-chaired the Oklahoma Health Care Reform Task Force. Cox is the only doctor in the state legislature. The pair helped expand Insure Oklahoma, a program that helps small businesses provide health care insurance for their employees. Steele said, “We have to increase insurance availability to improve the state’s health picture. We’re looking at reducing the uninsured.”
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They also help put together the All Kids Act, which allows families making up to three hundred percent of the federal poverty level to qualify for government assistance in obtaining health care.
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According to a 2008 report, “America’s Health Rankings: A Call to Action for Individuals & Their Communities” Oklahoma’s 3.5 million residents rank 44th of states from most to least healthy. “Oklahoma has issues with increasing rates of obesity and diabetics,” Steele said. Oklahoma has actually moved up four slots since 2007, when we were 47th. The report lists among the state’s challenges a high prevalence of smoking, a high rate of cardiovascular deaths and limited access to primary care. Since 1990, obesity in the state has increased by 148 percent. Oklahomans rank 48th in smoking and 43rd in obesity. We didn’t get there overnight, so education and lifestyle changes will take time. Keep in mind that in 1988, the Oklahoma legislature named Chicken Fried Steak the official state dish.
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On the positive side, according to the report, Oklahoma has strong per capita public health funding, due to the work of many in the public and private sectors dedicated to improving Oklahoma’s health picture.
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Steele said the ‘back-up plan’ would have to be formulated in the next legislative session. He said federal stimulus monies will make up the shortfall this year, but 2012 will be a different story. Steele didn’t express a great deal of optimism about achieving a ¾ majority on the bill in the upcoming session. Three comments about health care in Oklahoma:
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First, HB 2473 should never have been passed short of the three quarters approval of the legislature (36 in the Senate/ 76 in the House). When it was apparent it did not meet that threshold, the legislative leadership should have withdrawn the proposal. This ‘challenging’ of SQ #640 was time consuming, costly to taxpayers and unnecessary.
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Second, the answer to Oklahoma’s health care problems is complicated. How do we get Oklahomans to live healthy lifestyles? How do we insure more Oklahoma have access to affordable health care? How do we reform our tort system to prevent health care professional from leaving the state because of high malpractice premiums? We didn’t get here overnight and it will take time to fix it. Because Steele is considered to be one of the experts in the legislature on health care, as Speaker he will place an emphasis on the health of Oklahomans. That is a good thing!
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Third, Oklahomans need to start taking more equity in their own health. Rising health care costs impact everyone- not just the person receiving care. When the government pays a large majority of health care costs, your medical treatment is not just ‘your business’ anymore. ‘Your business’ ends where my wallet begins.