In opposing state exchanges and Medicaid expansion, Fallin is in good company. Louisiana Gov. Bobby Jindal has also rejected both, and Jindal is known for health care policy expertise. In the 1990s, he served as secretary of the Louisiana Department of Health and Hospitals. Jindal helped Louisiana's Medicaid program avoid bankruptcy while increasing childhood immunizations, raising Louisiana to third-best in health care screenings for children and offering new and expanded services for elderly and disabled persons. His record shows that Jindal is no knee-jerk opponent of aid for the poor.
Fallin's decision will no doubt put many hospitals in a tough spot since their business model now depends substantially upon federal money through Medicaid and Medicare — and Obamacare cuts $1.6 billion in Medicare payments to Oklahoma hospitals through 2020. Cost-shifting from the uninsured will remain a challenge as well.
We hope Fallin follows through on her promise to promote meaningful state-level health care reforms this year. The status quo is just as unsustainable as Obamacare. State government must now take the lead in addressing the very real health care problems facing Oklahomans.