With less than a week to go before he must choose when Oklahoma’s Medicaid expansion state question will appear on a ballot, Gov. Kevin Stitt hasn’t reached a decision on if voters will make their decision this summer or if they’ll have to wait for the fall.
Charlie Hannema, Stitt’s spokesman, told The Frontier Stitt was still undecided on whether voters will see State Question 802 on the summer or fall ballot. Stitt has until April 20 to make up his mind whether the state question will appear on the ballot on June 30 or the Nov. 3 general election ballot.
Medicaid expansion would provide coverage for thousands of low-income adults with incomes below 133 percent of the federal poverty level. Oklahoma has one of the lowest rates of insured citizens in the nation — a 2018 census survey found that 14.2 percent of Oklahomans lacked health insurance. Only Texas had a higher rate of uninsured citizens.
Speaking to a group of about 50 people at the Tulsa Press Club in late February, Stitt said he wasn’t in favor of the initiative because, in part, tying the expansion to the state constitution would leave the Legislature with little flexibility when it came to funding it in the future. He has called it an unfunded mandate and said that, if passed, the state question would result in deep budget cuts to state agencies.
While the government would match 90 percent of the cost of Medicaid expansion, Oklahoma would be on the hook for 10 percent of the expansion costs, which could total about $150 million a year.
Stitt has proposed an alternative plan, dubbed “Soonercare 2.0” that would expand coverage to more than 150,000 additional Oklahomans. He had proposed raising hospital fees to help fund the $150 million the state would have to cover, but it’s unclear how tenable that plan is now with the coronavirus pandemic damaging state hospital bottom lines.
Hannema released a statement to The Frontier that said providing Oklahomans “with a quality healthcare plan remains a priority of the Stitt administration, and conversations are ongoing with the hospitals.”
While voters wait for Stitt’s decision, House Minority Leader Emily Virgin criticized the governor for “waiting until the last minute.”
Virgin, D-Norman, said that with the coronavirus pandemic hanging over voters’ heads, and with questions about what the June 30 elections will even look like given social-distancing practices, voters need to know sooner rather than later what Stitt plans to do.
“It’s unfair to voters to wait until the last second for them to see if they’re going to have to vote, or if they’ll have to request absentee ballots or locate a notary to comply with the safer at home order,” Virgin said in a recent interview with The Frontier. “Really this problem has been going on before the pandemic and his opposition to the state question has led him to drag his feet.
“The issue is that this is popular among voters, and will likely be successful no matter what. I think both sides, those for it and those against it, need some certainty about when it will be on the ballot.”
Virgin said the expansion issue is “more relevant now than ever” because hospitals in the state are in a financial crunch at the moment with elective surgeries off the table, and some are being forced into large layoffs.
“It’s important to note that part of the reason the hospitals are suffering financially is because we haven’t expanded Medicaid,” she said. “If we had done Medicaid expansion just last year, (the hospitals) would have about a billion more dollars to deal with the pandemic and would not be laying people off when we really need all hands on deck.”
But the question, at least for now, is when voters will see it on a ballot. In 2018, former Gov. Mary Fallin placed State Question 788, which legalized medical marijuana, on the summer ballot.
“Fallin was certainly not supportive of that measure,” Virgin said, noting that opponents of State Question 788, which eventually passed overwhelmingly, believed it was less likely to garner support in the summer as opposed to the November 2018 ballot that was part of the expected “Blue Wave” of democrat voters.
“And while she didn’t support it, she still announced in January 2018 that she was putting it on the summer ballot, which was the responsible thing to do,” Virgin said. “It gave everyone, opponents and proponents, time to prepare and get their messaging together. But Stitt hasn’t even done that.”
JR Day, of OkiePolls, said he believes Gov. Stitt’s administration has waited this long because there’s not much evidence to point to which ballot would be worse for the state question.
“There’s just not a lot of evidence one way or the other, because state questions are funky,” Day said. “Some are easy to carve into partisan blocks and says Democrats are definitely yes and Republicans are definitely no, but lots of them don’t shake out that way.”
In 2016 a state question that enshrined the death penalty in the state’s constitution garnered support from voters on both sides of the Oklahoma aisle, despite polling nationwide that shows death penalty support is largely a Republican idea.
And in 2018 the state question allowed optometrists to open up shop in retail stores failed, and voting percentages there didn’t necessarily align with how some of the partisan races ended up, Day said.
“I think Stitt’s office has been looking for something to give them evidence to say one ballot is a better time to do the question than the other ballot,” Day said. “I don’t think they found that.”
There’s also the question of the coronavirus pandemic and how its shadow will likely be cast on any summer election. Some expect turnout to be lower than usual in June given the pandemic, but it’s unclear if a smaller turnout would be better or worse for opponents of the Medicaid expansion state question.
Earlier this month in Wisconsin, the state held in-person voting that created long lines of voters forced to break social distancing guidelines in order to cast a ballot. At stake was a state supreme court seat, and the democratic challenger, Jill Karofsky, managed an upset victory over the incumbent despite what democrat officials called “voter suppression on steroids.”
“I think having seen in Wisconsin, where even voting during a pandemic didn’t change the desired outcome, and just the general attitude of Oklahomans and Americans toward medical care right now, I think the deck would be stacked against Stitt if he put Medicaid expansion on the June ballot,” Day said. “In November, it will be much easier to try and tie the issue to Trump and have groups say ‘Hey, if you support Trump, then note no on Medicaid expansion. I expect to see it on the November ballot because it gives them a better opportunity to do that.”