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Editorial Roundup: Recent editorials in Oklahoma newspapers

February 5, 2019

Here are excerpts from recent editorials in Oklahoma newspapers:

Muskogee Phoenix. Feb. 3, 2019.

— Health care must be part of legislative focus

Oklahoma’s top Republicans laid out a legislative agenda they say was designed to restore trust and confidence in state government — a laudable goal by any standards.

Their top priorities include criminal justice reforms, increased investment in public education, and improvements in the delivery of government services. They cited a need to pass legislation in response to the voter-approved citizen initiative that legalized medical marijuana in Oklahoma.

All of those issues deserve attention given the fact the state is emerging from a shaky period of financial instability and some shady dealings at some state agencies. But one issue the majority party seems to have overlooked — and one that desperately needs to be addressed — is the disparity in health care coverage in this state.

Oklahoma is one of 14 states refusing to expand Medicaid through the Affordable Care Act, rejecting millions of dollars Oklahoma taxpayers send to the federal government but don’t get back.

The Affordable Care Act extended Medicaid eligibility to nearly all low-income individuals with incomes at or below 138 percent of poverty level, which in 2018 was $28,676 for a family of three. Medicaid expansion was intended to fill gaps for low-income households while tax credits available through the marketplace filled gaps for moderate-income households that lacked an employer-provided insurance plan.

A Kaiser Family Foundation analysis estimates there were about 142,000 adults in Oklahoma who would have been eligible for coverage in 2016 had the state expanded its Medicaid program through the Affordable Care Act. Instead, many of those Oklahomans end up in an emergency room when they require medical attention, and because they lack the means to pay it drives up the cost of care for all.

The costs of providing uncompensated care has taken a toll in Oklahoma, with rural hospitals and clinics closing their doors and health outcomes stalling or on the decline. With the state seeking further restraints on Medicaid eligibility in the way of work requirements, the pace of any decline likely will accelerate.

If Oklahoma is going to be a Top 10 state, it’s got to have a healthy population — people who can fill those new jobs expected to be offered. This is the year lawmakers — and the governor — need to seriously consider accepting federal dollars through Medicaid expansion and free up some other funds for other needs like infrastructure.

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The Oklahoman. Feb. 4, 2019.

— Raising Oklahoma’s smoking age merits debate

To reduce Oklahoma’s tobacco-related health woes, the American Lung Association is urging lawmakers to raise to 21 from 18 the legal age to purchase tobacco. It’s an idea that deserves serious consideration.

At one time, such calls would have been dismissed outright. Critics would argue that if 18-year-olds are mature enough to serve in the military and put their lives on the line, then they’re old enough to determine if they want to risk their health by smoking.

But attitudes have changed, and few people today argue smoking has any genuine positive benefit, let alone benefit that outweighs the harm done to one’s health. Plenty of smokers wish they had never begun the habit and are vocal about that fact, and they are often supportive of efforts to deter others from initiating tobacco use.

More importantly, there’s evidence that suggests raising the smoking age to 21 would have a deterrent effect.

The Campaign for Tobacco-Free Kids notes about 95 percent of adult smokers begin smoking before age 21. The group argues that the ages of 18 to 21 are “a critical period when many smokers move from experimental smoking to regular, daily use. While less than half of adult smokers (46 percent) become daily smokers before age 18, four out of five do so before they turn 21.”

Critics may note the 46 percent who started smoking daily before age 18 did so despite laws that make sales to minors illegal and ask how adding three years to the prohibition would have any significant effect. The Campaign for Tobacco-Free Kids responds, “Research shows that kids often turn to older friends and classmates as sources of cigarettes.” Thus, raising the legal age to 21 to purchase tobacco would “reduce the likelihood that a high school student will be able to legally purchase tobacco products for other students and underage friends.”

Put simply, 21-year-olds don’t usually hang around with 16-year-olds, so bumping the legal age of purchase to 21 reduces teenagers’ social access to tobacco.

A 2015 report by the Institute of Medicine (now called the National Academy of Medicine) found that raising the minimum age of legal access to tobacco “will likely prevent or delay initiation of tobacco use by adolescents and young adults. The age group most impacted will be those age 15 to 17 years.”

The report estimated that raising the minimum age of legal purchase to 21 would produce a 12 percent decrease in the prevalence of tobacco use among today’s teenagers by the time those kids are adults.

If the legal age nationwide were raised to 21 today, the research estimated, “there would be approximately 223,000 fewer premature deaths, 50,000 fewer deaths from lung cancer, and 4.2 million fewer years of life lost for those born between 2000 and 2019.”

Rep. Ben Loring, D-Miami, has filed legislation to raise Oklahoma’s smoking age to 21. That bill should not be dismissed without serious consideration. Only six states have enacted similar laws, but legislators should keep in mind there are times it’s good to be on the front edge of a trend, particularly when lives may be saved in the process.

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Tulsa World. Feb. 5, 2019.

— Gov. Kevin Stitt got a lot right in his first State of the State speech ... but not everything

We saw much to be encouraged about in Gov. Kevin Stitt’s first State of the State speech on Monday.

He outlined a strong program of reform, transparency and appropriate funding of critical areas of state government.

Beyond any particular policy, we found clear evidence in the speech that Stitt is a quick study of government issues. From very little political background, he has quickly grown to understand the detail and nuance of state government.

Here’s one key example: Stitt said he wants to “move the needle” on education outcomes during his time in office, but says in the very next sentence that, “we must first continue our investment in the teacher.”

Amen. What do we all want? More effective educations for the children in public schools. But how can we get that if we don’t first fund schools, and teachers in particular, appropriately? Stitt understands that we cannot. The funding comes first, then we can accomplish many great things.

Overall, we found that we agreed with Stitt on many issues but not his comments about state acceptance of available federal funding to increase health care coverage broadly in the state and buoy the finances of struggling rural hospitals. Stitt has remained open to the idea recently, but in Monday’s speech he urged caution about the plan.

Using a red herring argument concerning federal funding of medical residencies at Oklahoma hospitals, Stitt said federally promised Medicaid funding may not be reliable. We think Stitt is drawing the wrong conclusion from the medical residency experience, and we pray that he remains open to further evidence on the potential for federal funding to transform the nature of Oklahoma health care.

We found hope for that earlier in Stitt’s speech, when he reached out to lawmakers with these words: “I want to make it clear: as elected officials, we will not always agree on the specifics of every policy — and that’s OK. We are each elected for different reasons and because of specific issues.

“But you will always find my office willing to work with you and to be open minded on policy differences, because what unites us in this room is that we are committed to reimagining how we can do state government better and deliver a brighter future for Oklahomans.”

That is the sort of open-minded, evidence-based, outcomes-oriented decision-making Oklahomans believed they were getting when they voted for Stitt, and, in many ways, it was the most important thing we heard on Monday.

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