OKLAHOMA CITY (AP) — Because of bitter opposition to the new federal health care law in Oklahoma, state officials have done little to comply with it and instead are gambling that a key provision will be struck down Thursday by the U.S. Supreme Court.
Chief Justice John Roberts is expected to reveal the high court's verdict on President Barack Obama's health care overhaul shortly after 9 a.m.
The move is calculated — albeit risky — for Oklahoma's GOP leaders, who cited fears of a federal takeover of health care in declining to set up a state-run health insurance exchange. Should the law be upheld and the state doesn't create its own exchange by November, the state would automatically be absorbed into the federal system — the very thing they're fiercely trying to avoid.
"Like many states, Oklahoma has opted to see whether or not the federal health care law survives a challenge in the U.S. Supreme Court before acting on an exchange," said Alex Weintz, a spokesman for Republican Gov. Mary Fallin. "The governor's hope is that the law is overturned, allowing states to pursue their own health care solutions that emphasize choice and free-market competition rather than being saddled with ineffective and costly mandates from the federal government."
But Weintz acknowledged Fallin has not decided how to proceed if the law is upheld, saying she plans to discuss those options after the ruling.
In a state that filed a federal lawsuit claiming the law is unconstitutional and where nearly 65 percent of the voters in 2010 favored a constitutional amendment that prohibits forced participation in a health care system, Republican lawmakers are clearly in no hurry to comply with the law.
The resistance to the new health care law was so fierce in Oklahoma that the Legislature rejected $54 million in federal money to set up the exchange, mostly because of fierce opposition from tea party activists and other conservatives who maintain the plan would inextricably link the state to new federal requirements. When lawmakers decided to study how the state could set up and fund its own health insurance exchange, conservative activists were so relentless in their opposition that the Legislature ultimately decided to do nothing.
"If the court rules for the individual mandate, we're going to be a little behind the curve and we'll have to be playing catch up," acknowledged Republican state Rep. Doug Cox, an emergency room physician from Grove who served on the legislative study committee. "I think what we're really betting on is the presidential election this fall."
But even if Republicans were to take back the White House and the Senate, states still face a November deadline for having an exchange plan in place.
Ironically, the Republican Legislature approved a bill to create a health insurance exchange in 2009 that was signed into law by former Democratic Gov. Brad Henry, but because of a budget crisis, there was never any money appropriated to fund its creation.
"At the time, that was seen as a very conservative idea," Cox said. "Since Obama got elected, it's gone from being a conservative idea to a liberal one."
By the next year, Cox said the federal health care law had become so politically toxic in a state where President Obama failed to win a single one of its 77 counties in 2008 that lawmakers were hesitant to support any proposal that could be linked to the federal health care law.
"That's exactly what's going on," Cox said. "It is the face of a president who is very disliked in Oklahoma."
And while Oklahoma has done little to prepare for the law being upheld, the state also has few options for dealing with the estimated 17 percent of Oklahomans without health insurance if the law is struck down, said Kevin Gordon, the president of Crowe & Dunlevy and chairman of the law firm's Health Care Litigation Practice Group.
About 625,000 Oklahomans, most of them adults, currently are uninsured, according to the latest figures from the Oklahoma Health Care Authority.
"We're also ill-prepared for the law to be overturned," Gordon said. "We're going to have challenges either way. If it's overturned, we still have the underlying problems with considerable increases in health insurance premiums over the next several years."
Gordon and Cox both said one option Oklahoma has for addressing the problem of those without health insurance is expanding the state's Insure Oklahoma program, which is administered by the Health Care Authority and supported by Fallin.
The program, which currently insures about 30,376 Oklahomans , is designed to bridge the gap in health care coverage for low-income workers by allowing premium costs to be shared by the state (60 percent), the employer (25 percent) and the employee (15 percent).
It also has an individual plan that allows self-employed or unemployed workers to buy health insurance directly from the state. The state portion of the program is funded through an increase in the sales tax on cigarettes that