State of health
Area legislators kicked off the Ardmore Chamber of Commerce’s legislative luncheon season with a topic currently hot on everyone’s mind as well as one that’s been somewhat lost in the weeds in recent months.
State Sen. Frank Simpson, R-Springer, and Rep. Tommy Hardin, R-Madill, briefed those in attendance on current activity at the capitol while trying to reign in some of the mass hysteria currently revolving around the ongoing coronavirus pandemic.
Simpson kicked off the event by giving a quick rundown of recent activity at the statehouse, including an update on ongoing budget negotiations.
“That’s kind of our priority, no matter what gets done, the budget has to get done,” Simpson said.
While a decline in oil prices is expected to impact state revenues, Simpson said the the state was currently capable of handling short-term declines due to recent savings — about $1 billion — stashed away in the state’s rainy day fund.
“The budget we are working on this year was budgeted on oil being at $52-53 a barrel,” Simpson said. “That is going to affect our revenue picture… We are probably in better shape today than we have been in the last 10-12 years.”
Simpson said recent efforts to diversify the state’s economy should also help soften the blow.
He said that the ongoing coronavirus response is reviving staffing issues from previous years with the state’s health department, specifically reductions to staffing that resulted from the department’s misplacement of $30 million in 2018.
Simpson said a request to expedite rehires is using the coronavirus for justification but is being stalled to insure the new hires are needed to respond to the ongoing pandemic. Part of the request would also reclassify the positions to remove them from the state’s merit system and also remove them from the state’s veteran’s preference program, which provides veteran applicants a competitive edge against civilian applicants. Simpson said the reclassification would also remove employee protections for the new hires.
“I don’t want to use the coronavirus scare as a reason to move all these positions to unclassified just to find out that 99% of them didn’t have anything to do with the coronavirus problem,” Simpson said.
Thrown into the mix, the state is currently being forced into a decision on the expansion of Medicaid with Gov. Kevin Stitt recently announcing his plan to opt into President Donald Trump’s Block Grant proposal in contrast to an upcoming State Question that would expand Medicaid based on current funding mechanisms.
“I’m hearing all kinds of different numbers, and I don’t know what the right number is on how much we will have to come up with if we do this,” Hardin said. “We might expand it and the next thing we know, we’re in trouble and we have shortfalls. If it’s put into the Constitution, then it’s money off the top. Right off the top, that’s the first thing we have to get funded. Then what happens to the other services we need? They have to be cut.”
Attendees also asked about SoonerCare 2.0, the governor's plan for Medicaid expansion in the state.
“First of all, there is no plan,” Simpson said. “All the governor has on it, it’s actually a form where you check the boxes. It’s not a written plan, it’s not ‘here is what we are going to do.’ It’s really just a blank template… There is no plan out there that we have seen in the Senate… We are still kicking around how much it’s going to cost, and there is no money appropriated for any plan. We have not had any budget, any legislation to authorize any expenditures for any Medicaid expansion.”
Simpson cited budget constraints and the “woodwork effect” faced by other states after expanding Medicaid as creating a sense of hesitancy within the legislature on approaching expansion.
“You offer something for free and people come out of the woodwork to take advantage of it,” Simpson said. “The problem states have gotten, they have severely underestimated what would come out and take advantage of it (Medicaid access) and it has really caused their Medicaid spending to go through the roof.”
SImpson cited the state rankings for healthcare spending versus results in advocating for a change in the way healthcare is approached by the consumer.
“We are spending a lot of money to treat people but we aren’t getting any bang for our buck,” Simpson said. “If we do expand Medicaid, we have got to look at a managed plan. What that does, you hire a contractor to manage your Medicaid and they actually make sure people show up for their appointments, they take their medicine, if they say ’I don’t have a ride to my appointment,’ they get them a ride to their appointment. They make them adhere to a regimen to try and make them healthy. Because if all we are going to do is expand Medicaid and insure more people, and they come to the doctor and we pay their bills but they continue to smoke or eat fatty foods or not exercise and do all the things that are bad for their health, we are just spending more money and getting the same status of health that we have now.
“There is a cultural aspect that has got to be overcome. We have a whole culture out there that has never understood the value of having a primary care physician that they see on a regular basis. They’ve become accustomed to ’they're sick so they go to the emergency room, they get treated then they go back home,’” Simpson said. “It’s extremely expensive. If they don’t have relations with a physician that knows their history, their health, their family that can help contribute to improving their quality of health, if we can't change that, then we are just spending more money and not getting anything in the end.”
SQ 780 savings
“780 was well intended but all it did, to an extent, was take a service the state was shouldering and passed it down to the county,” Simpson said. “I don’t think we will see any savings from 780 for quite a while.”
A piece of legislation is currently passing through the legislature that would allow DA’s to combine multiple larcenies to reach the current $1,000 threshold, allowing for stiffer penalties for habitual offenders, though Simpson said he was not aware of any legislation allowing the same for drug possessions currently in the works.
“If you say we just don’t want as many people in prison, well then you just don’t try as many people that commit crimes,” Simpson said as an alternative to SQ 780. “But I don’t think 780 has had near the impact that they thought it would.”
When asked about the legislature’s intentions of creating additional funding for the companion element of State Question 780, State Question 781, Hardin responded with “What is 781?”
“I thought 781 was supposed to be funded with money we saved from 780,” Hardin said after Simpson refreshed his memory. “That was imaginary money to begin with on what we projected to save, no I don’t see how we can fund it.”
State Question 781, passed as a companion with SQ 780, would have used savings from the state due to reduced spending on incarcerating offenders to provide mental health and substance abuse resources to communities.
“That’s the rehabilitation aspect of 780 and we don’t see any savings from 780 so we aren’t going to do anything with 781,” Simpson said.