"We feel like we have kept, as of right now, the doors open for the state of Oklahoma to pursue whatever we decide is the best option for our citizens," Weintz said. "We don't feel like anything has been ruled out, simply because of time restraints, at this time."
States initially had until Nov. 16 to provide federal officials with a blueprint for how the state-based exchange would work, but Health and Human Services Secretary Kathleen Sebelius said in a letter to governors Friday that they have another month, until mid-December, to submit detailed plans. Sebelius noted that she still wants to hear by the end of next week if states plan to set up a state exchange. States that don't will have a federal exchange operated for them.
Nearly 20 percent of Oklahoma citizens currently are uninsured, and an expansion of Medicaid to 133 percent of the federal poverty level would make an additional 180,000 adults eligible for Medicaid, according to the Oklahoma Hospital Association, one of the groups pushing Fallin to support the Medicaid expansion.
State health officials estimate such an expansion would result in more than $1.5 billion in federal funding to the state during the first three years when the federal government picks up the full cost of the expansion. The state's share would grow to 10 percent of the cost by 2020, which would amount to about $56 million, according to estimates from the Oklahoma Health Care Authority.
But those federal and state costs are why the Medicaid expansion is being opposed by conservative activists and Republican U.S. Sen. Tom Coburn, Oklahoma's junior senator who has railed against increased federal spending.
"I do believe our state Medicaid's program can help Oklahomans who qualify for the program," Coburn wrote in a letter to Fallin last month urging her to reject the Medicaid expansion. "But at a time when our national debt is $16 trillion and Congress is running trillion-dollar annual deficits, it is unlikely that federal promises of stable Medicaid funding are anything more than a mirage."
Sean Murphy can be reached at www.twitter.com/apseanmurphy