Already facing pressure from national conservative organizations and others to reverse the state's decision to participate in the federal Affordable Care Act, Gov. Mary Fallin's position appeared to become untenable when she lost legislative support for a key provision of the program.
On March 31, 2011, Fallin's chief of staff sent a one-word email after learning the Senate would not take up a bill that Fallin championed to create a state health insurance exchange.
“Dammit (sic),” Denise Northrup wrote.
“What's the plan now?” responded Rep. Jason Nelson, R-Oklahoma City.
Two weeks later, Fallin announced that the state would not accept a $54.6 million federal grant that would have been used to help set up the exchange. Instead, Fallin set out to develop the state's own system where Oklahomans could shop for health insurance, before later abandoning that plan, as well.
The emails were included among 51,029 pages of documents released Friday afternoon by Fallin's office in response to an open records request for information about how state officials made decisions on whether to participate in the federal health insurance program, also known as Obamacare.
In its request made in November, The Oklahoman asked for all emails relating to Fallin's decision first to accept and then to reject the federal health care money.
Lack of support
Fallin already was facing pressure from national Republican leaders to reject anything to do with Obamacare even before she lost the support of Oklahoma Senate leaders.
The records show that Sen. Tom Coburn, R-Muskogee, was one of many to reach out by email to Fallin to oppose the expansion.
“Oh, how kind,” Northrup wrote when notified of Coburn's input.
Initially, Fallin supported creation of the exchange saying it would provide consumers with more choices to help improve access to affordable plans.
“Regardless of any federal assistance the state does or does not receive in the future, she will continue to support the creation of such an exchange,” her spokesman, Alex Weintz, wrote in a February 2011 email.
The lack of Senate support appeared to catch Fallin's staff off-guard.
About a week before, Fallin sent a letter to Oklahoma lawmakers asking them to pass House Bill 2130, which would have established a framework for the exchange.
“If we do not pass HB 2130 the results will be devastating for those of us who oppose Obamacare and the federal intrusion it represents,” she wrote. “Without an Oklahoma exchange, the state is virtually guaranteed to be subject to a federally run, Washington, D.C., substitute. And unlike the one we develop here in Oklahoma, that federal exchange will rely on public health care plans and be funded by public debt for many years to come.”
She asked lawmakers to join her in supporting a “free-market conservative exchange and defend Oklahoma against federalization of our health insurance.”
Sen. David Holt, R-Oklahoma City, responded to the letter with a March 22, 2011, email to Fallin's policy director, Katie Altshuler. Holt said he was hung up on the cost.
“$50 million is a lot of money for something that I don't even think is a core government function, and though I may have felt different 10 years ago, I no longer view federal money sent to states as ‘free money,'” Holt wrote.
“I don't have any strong dispute with the policy argument presented in this letter, but the cost is really a problem for me. Any argument you have to address that concern is welcome.”
A week later, Senate President Pro Tem Brian Bingman announced the bill would not be heard.
Friday, Bingman said he could have done a better job of informing Fallin of his intentions to not support the legislation.
“But at the end of the day, I think we all realized we made the right decision,” he said.
Bingman said the decision to not support the exchange was made by the Republican caucus in the Senate and not him alone.
Bingman's Republican counterpart in the House said he, too, was blindsided by Bingman's announcement and by what he described as Fallin's “flip-flop.”
Former Speaker Kris Steele, R-Shawnee, said until Bingman's news conference, all three supported the exchange.
“I don't know if it's normal, but it seems very odd to me given the discussions that we had up until that point,” Steele said. “We had talked about the issue (and) she stated privately she was supportive of the legislation we moved through the House.”
A spokesman for Fallin could not be reached for comment.
Rep. Scott Inman, D-Del City, current House minority leader, said he, too, doesn't understand why Fallin so quickly changed her mind.
“I'm disappointed that the governor wouldn't exert more leadership,” Inman said. “If she really felt it was the right thing to do — which she must have at some point because that's what she said she wanted to do — then I would have hoped she would have the leadership to stand up and implement it.”
Fallin would continue for more than a year to support some form of a health insurance exchange, even as lawmakers threw up more and more objections.
In November 2012, Fallin's spokesman sent an email to Northrup asking whether Fallin could create an exchange on her own without the Legislature.
“My understanding is the simple answer is yes she can, and no she does not,” Weintz wrote. “Is that correct and is that how we want to say it?”
Northrup responded: “OMG you are killing me. ... That is correct but I'm pretty sure we don't want to say it that way.”
Not long after, Fallin announced Oklahoma would no longer pursue an exchange.
Joseph Stipek, Staff Writer