Alva Review-Courier -

After a decade of opposition, Oklahoma's Republican leaders signaled a willingness to expand Medicaid to cover more low-income adults, although Oklahoma voters will have the final say on exactly what that expansion looks like.

Just days before the start of Oklahoma's legislative session, Gov. Kevin Stitt embraced a proposal from President Donald Trump's administration to expand health coverage for the working poor that would give states more control over spending, but cap how much the feds kick in. Republican leaders in the House and Senate said they were excited to work with Stitt on the details of the plan, which will be hammered out during the legislative session that starts on Monday.

That plan is likely to include modest copays and premiums for the expansion population, along with a requirement that able-bodied recipients without children work, go to school or volunteer in the community.

Whatever plan GOP leaders develop, it will be competing with a full-scale Medicaid expansion through State Question 802, the result of an initiative petition that qualified the proposal for the ballot. Stitt has been a fierce critic of the proposal and told reporters Thursday he thought the plan would be "disastrous" and lead to budget cuts to state agencies.

Both plans would extend coverage to those who earn up to 138% of the federal poverty level, which is about $17,200 for an individual or $35,500 for a family of four.

Oklahomans should be wary of the latest proposal unveiled by the Trump administration, which almost certainly will result in cuts to either eligibility, available services or reimbursement rates, said Leonardo Cuello, director of the Washington, D.C.-based National Health Law Program.

"(The U.S. Department of Health & Human Services) is not interested in increasing the outlay for a state. What they're hoping for is to find some governor to act against the interests of his own state, to reduce funding for his own state because of some ideological belief that we shouldn't be providing health care to people," Cuello said.

In addition to working on Medicaid expansion details, here are some other issues to keep in mind as the Legislature starts its four-month session:

PAY BOOST FOR RETIREES

The Oklahoma House last year approved a 4% cost-of-living increase for Oklahoma's public pensioners, but the plan died in the Senate, where members wanted a more detailed study. Now that the study has been completed, House Speaker Charles McCall said Thursday he's confident the pay boost will make it to the governor's desk this year.

GUBERNATORIAL POWER

The Legislature last year also expanded the governor's power, giving him the ability to hire and fire the directors of the state's largest agencies. Stitt has signaled he wants even more power, such as appointing the now-elected state superintendent of public education and consolidating state agencies, and the Legislature seems inclined to give it to him. Senate President Pro Tempore Greg Treat said the changes made to agencies last year have given legislative leaders the ability to appoint board members, which has given lawmakers more insight into agency operations.

FLAT BUDGET

While lawmakers last year enjoyed a surplus of nearly $600 million, they won't have that luxury this year, with a projected flat budget of about $8.3 billion. That could make it difficult for the governor or lawmakers to expand or develop new spending projects, especially when the governor also has indicated a desire to sock more money into savings.

"It's a lot easier for all of us to get along when we have extra money to spend," said Senate Democratic Leader Kay Floyd. "We're not going to have that luxury this year."