Decisions of politics and compassion

We know what is causing the pain. Jane has a bad gallbladder that is full of stones — easy to fix. In the hospital Friday morning for surgery, home Friday afternoon, back at work Monday morning.

Like hundreds of thousands of hardworking Oklahomans, Jane has no insurance and no way to pay for the surgery.  With two kids, she and her husband work at minimum-wage jobs for small companies that don’t provide health insurance.

They would be covered by the expansion of Medicaid under the Affordable Care Act (ACA), commonly known as Obamacare.

By now you know that Gov. Mary Fallin decided that Oklahoma will not participate in that expansion, which would provide health insurance for Oklahomans making less than 133 percent of the federal poverty level. For a family of four, 133 percent of the federal poverty level is $30,657. The cost of health insurance for a family of four averages $5,167 annually. It is simply unaffordable.

I have no doubt the governor made the right decision from a political standpoint. Emails and calls to my office are overwhelmingly against Obamacare.

The fact is, it is now the law, whether we like it or not.

The federal reimbursement for expansion of Medicaid would have been 100 percent of the cost through 2016, and then gradually decreasing to 90 percent by 2020. This means the estimated cost to Oklahoma, if 75 percent of those eligible were to participate, would be $27 million in 2017 and increase to $56 million by 2020. This is a doable number.

Oklahomans will still have to pay federal taxes and penalties for not having health insurance. With the governor’s decision, our money will be used to expand the program in other states, while our citizens continue to be uninsured.

Oklahoma hospitals currently receive supplemental Medicare money (called disproportionate share hospital, or DSH, payments) to offset the cost of caring for the uninsured. These payments will decrease or be eliminated as a way to finance the federal share of the health plan. Since Gov. Fallin chose not to participate, Oklahoma hospitals will still lose the DSH payments and not be able to recoup the loss through Medicaid expansion. To make up for this lost revenue, hospitals will need to raise prices for insured patients, pay out of pocket or risk closure.

I respect the governor’s decision, but I deal every day with good people who need but cannot get access to medical care. Right or wrong, my compassionate heart overrules my political mind.

John has hepatitis C. He didn’t get it from drug abuse. He was infected from multiple blood transfusions after a motorcycle wreck as an adolescent. His hep C is active, causing cirrhosis. John is unable to afford the medication to treat his condition. He certainly can’t afford a liver transplant. Unless John moves to a state that is expanding Medicaid under the ACA, he could die of this treatable disease.

Living in Oklahoma may be John’s death sentence. That is not what I want Oklahoma to be known for.

Cox, an emergency room physician, is a Republican from Grove  representing District 5 in the Oklahoma House of Representatives.

Rep. Doug Cox

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