Rather than concentrating solely on health care reform, Gov. Mary Fallin plans to focus her attention in the upcoming legislative session on how to improve the overall health of Oklahomans.
Oklahoma has long had some of the worst health rankings in the nation, with the state facing high rates of obesity, heart disease, diabetes and poor mental health.
Fallin spokesman Alex Weintz said most of those negative outcomes are not related to the availability of medical treatment or health insurance but instead to preventable illnesses.
“The greatest contributors to Oklahoma's poor health rankings are high rates of smoking, substance abuse and obesity,” Weintz said. “The governor is continuing to focus on initiatives that encourage healthy life choices and address the root causes of poor health in Oklahoma. One of the many unfortunate things about Obamacare is it has been a distraction, rather than a solution, to the real problems that are driving up the cost of health care and making people sick.”
Fallin will reveal more details on her health plan on Monday during her State of the State speech.
Where the money will come from to finance that plan has not been announced, but some of it is anticipated to come through existing programs and funding increases to some health-related state agencies, Weintz said.
Health leaders say the state has not seen a comprehensive approach to improving its health come out of the Legislature in several years.
Oklahoma ranks No. 43 in its overall health, facing a growing number of residents with chronic disease, and a limited number of primary care physicians, according to the United Health Foundation's annual health rankings.
State Health Commissioner Terry Cline called Fallin's approach “visionary.”
“It would have been very easy to say we're simply going to look at our existing system and let it expand or contract,” Cline said.
Instead, Fallin has been focused on how to improve residents' health outcomes and what the state can do the cut down on the cost of health care, Cline said.
“The cost trajectory we have is unsustainable, so we have to do something to bring those costs down, and we know that access to care is important, so what can we do to increase access to care, improve health outcomes and bend the cost curve?” Cline said.
Cline said the Affordable Care Act does not take the same approach and provide enough of an answer to the problems Oklahoma faces in residents' overall health.
It's possible to change how residents view their health, the things they eat and the amount they exercise, but it takes time and the proper amount of funding targeted strategically, Cline said.
Cline gave the example of smoking indoors and how not that long ago, people could smoke inside the Oklahoma Capitol.
“We have the changed social expectation around that, so that tells me we can do this too,” Cline said. “ ... To me, it's not a question of whether it will be done or if it can be done, because the answer is yes to both of those, the question is — how quickly can we do it?”
In November, Gov. Fallin announced Oklahoma would not expand its Medicaid program or create a state-run health insurance exchange. Both provisions are part of the Affordable Care Act, the federal health reform law that is known as “Obamacare.”
By not expanding Medicaid, critics of Fallin have argued that Oklahoma is missing out on millions in federal dollars it would receive to cover thousands of uninsured low-income adult residents.
In 2010, about 691,000 residents were uninsured, representing about 22 percent of the state's population, according to the U.S. Census Bureau.
Sen. Sean Burrage, D-Claremore, filed a bill for the upcoming legislative session, which begins Monday, that would require Oklahoma to expand Medicaid.
Burrage, the minority leader in the Senate, doesn't think the bill will go far but filed it because he wants to keep the conversation around Medicaid expansion going.
“In Oklahoma, we have the opportunity to get health insurance for 180,000 low-income working adults that don't have access to health care now,” Burrage said.
Reuters reported that four Republican governors in Arizona, Nevada, New Mexico and North Dakota have come out in support of expanding Medicaid.
Waiting for ideas
Burrage said it's not too late for Fallin to change her mind. The state already receives about $3 billion in federal money for Medicaid, and the money it would receive to expand Medicaid shouldn't be viewed any differently, Burrage said.
Burrage said he looks forward to hearing more about what Fallin's goals are for improving Oklahoma's health.
“I have not heard anything, other than what I've read in the paper, and the first paragraph of an article in your paper or the Tulsa World said we're going to come up with a plan that uses state and federal dollars,” Burrage said. “I stop right there — are we having another plan just because that way it's not considered to be the Affordable Care Act or do we really have a better idea?”