There are many within state government who understand that the long term fiscal impact of the federal health care law will be devastating. While the federal government may attempt to incur much of the expense up front, the policy clearly intends to shift massive amounts of cost to state government.
State Represenative Jason Murphey
For the past several months, state leaders have anxiously awaited the Supreme Court decision on the policy and the 2012 presidential elections. Had the court struck down the law or had Republicans won the election, the law could have been reversed and state government might not have been forced to make very tough decisions.
Because of the election results, the next legislative session has become very important and here is why:
Under the national health care proposal, state governments are allowed to make decisions as to the extent that the proposal is implemented. Those decisions are subject to coercion by the federal government because of their threat to reduce funding to the states.
Fortunately, components of the Supreme Court’s ruling greatly strengthened the position of state governments. The Court’s decision took away some of the federal government’s ability to act punitively against state governments that fail to implement the proposal’s costly provisions.
This doesn’t change the fact that there will be a lot of fear mongering by those who want state government to give into federal demands and who will suggest all types of Armageddon-type outcomes should the state fail to implement the various provisions.
However, I believe those who are aware of the states’ rights under the Supreme Court decision will be able to keep the advocates of accepting federal mandates at bay. The federal government will also be inhibited from activating aggressively due its own looming financial crises and a divided Congress. These will make it difficult for the federal government to fund components of the plan that state governments refuse to fund.
Regarding health care implementation, there will likely be two foremost schools of thought in the Legislature.
One group will fail to show innovation and simply want to comply with the federal government either out of fear, because they are motivated by the special interests that benefit from the implementation of yet another big government program or because they do not have the imagination to dream of the day when Oklahoma would become liberated from federal mandates by rejecting federal money.
The other group will likely propose innovative ideas to free Oklahoma of federal health care mandates and return these programs to local-level control. Doing this may mean rejection of a substantial amount of federal dollars, but should allow the state to design a much more efficient substitute for Medicaid that will make up for the loss of federal dollars while improving the performance of the the program to those who are trapped within it. They will suggest designing a plan that isn’t as susceptible to fraud as the existing Medicaid program and allows legitimate plan participants to control their own destiny through the infusion of market-driven concepts. They may attempt to not just move the state away from the continued federalization of health care policy, but to also provide innovative solutions in an effort to protect Oklahoma taxpayers and employers from the tax penalty implications of the federal program.
I am starting to suspect that the federal health care proposal and this year’s election might have been the final straw that pushes state governments over the line to the point where they will have the courage to reject federal funds and the punitive mandates that come with them. The governors of Florida, Virginia and Kansas have already made it clear that they will not implement components of the plan. Oklahoma should follow their lead.
Thank you for reading this article. Your interest and input are much appreciated. Please do not hesitate to email Jason.Murphey@hd31.org with your thoughts and suggestions.
The sun is shining. Good things are happening all around me. I am happy to be alive. I will not live in fear.