Hiett sees change in legislative direction

Capitol Spotlight for weeklies for week of Feb. 5, 2006
By Jim Campbell
OPA Capitol News Bureau
For House Speaker Todd Hiett, the deficit-cutting bill on the President's desk underscores the need for the Medicaid reforms his task force is recommending and illustrates why the business of government is changing in Oklahoma.
"It is the reason we feel it is so important that we overhaul Oklahoma's Medicaid system," said Hiett, R-Kellyville, in an interview marking the start of his last session.
Term limits make it the last session for the first Republican speaker in 82 years and the last of 12 years in the Legislature. 
Once considered likely to challenge Democrat Brad Henry for governor, he is now seeking the GOP nomination for lieutenant governor and could be the general election opponent of House Democratic leader Jari Askins of Duncan. Both will have primary races, Hiett notably opposing Tulsa Sen. Scott Pruitt.
The budget-cutting bill passed by just two votes in the U.S. House Feb. 1, makes some cuts in federal Medicaid funding and allows states to reduce Medicaid coverage and raise fees charged to poor and disabled recipients.
 "We'll be the first state in the nation to completely overhaul the system," he said.
Washington used the "carrot approach" encouraging states to build large populations dependent on the federal-state healthcare program, then started pulling back its dollars and leaving the states to cope with increasing demands for coverage, he said.
Hiett last year named a task force headed by Rep. Kris Steele, R-Shawnee, to find $100 million in program abuse and fraud and to redirect the savings into more health care for the underprivileged.
This followed Hiett's refusal to go along with a provider fee on hospitals that would have leveraged a greater portion of federal funding.  Democrats in the House and Senate say that concept will be before the Legislature again this year, since mostly only specialty hospitals are opposed to providing a continuing source of state dollars for Medicare.
One of the task force proposals is for a stable revenue source out.
Although the governor, Senate leader and others were skeptical, Hiett said the panel identified $111 million in Medicaid waste and then went on to plot a roadmap to a thorough revamping the system in Oklahoma.
"I don't believe that kind of savings can be found," said Democratic Gov. Brad Henry. "I'm anxious to see that. I would be very surprised if there is $100 million waste in Medicaid."
"They did it," Hiett said. "It's there."
He said the Oklahoma Health Care Authority (OHCA), an agency that could have been adversarial, pitched in and helped. 
"They knew we were serious," he said.
The task force found $93 million in savings over three years by cutting 3 percent from the OHCA's error rate of 9.58 percent, nearly $12 million in diverting one in five from expensive emergency room care and $6 million by increasing from three years to five the period in which a person must spend down assets to qualify for Medicaid.
"That's the first step," he said. "It's just the beginning."
The next step, he said, is providing incentives for people to choose what works best for them, from such options as health savings accounts and using Medicaid benefits to join an employer-sponsored health plan.
"If just handed a blank check in terms of health care," he said, people "are not going to be good stewards."
HHH
Citing a growth of conservatism in the Oklahoma Legislature, Hiett said the biggest change he has seen in his six terms is "the way the Legislature does business." The emphasis now is more on empowering the people to help themselves than on government programs.
As an example, Hiett, former Congressman Wes Watkins and members of the House Rural Economic Development Initiative delivered a package to encourage investment and growth in the countryside.
"The people have said government programs have been tried in rural Oklahoma and didn't work," Hiett said.
At the outset, Hiett did not see major conflicts with the governor and said the first agreement of the year, fixing Oklahoma's dangerous roads and bridges could come quickly.
"The governor and I have different visions for the state but we have an ability to work together as shown in the last legislative session," he said.
"Everything is on the table," he said. "That's the way it works. But at the end of the day we need results."
Democrats complained last year that Henry was not invited into the budgeting process. But Hiett said that was only while setting out base line amounts in the General Appropriations bill, "where there was no reason" for the governor to be involved.
"But in the final budget negotiations is where everyone should be at the table," he said.
With regard to tax relief, both Henry and Hiett have said everything is negotiable.
A major plank in the GOP program is total elimination of the estate tax, which Republicans like to call the "death tax," while Henry supports extending half the exemption now covering direct lineal heirs to collateral heirs. Oklahoma's exemption now is $1 million. The federal level is $2 million this year and scheduled to rise to $3.5 million by 2009. 
"End the death tax" under Hiett's House Bill 3125 also topped recommendations of the Rural Economic Development Initiative task force, saying it hurts small business owners and family farmers and discourages investment in the state.
Another highlight of the program is the "Come Home Oklahoma" Act, HB 3126, giving a five-year income tax exemption to anyone who moves into one of 48 counties or more than 40 cities that have lost population and builds or buys a single family dwelling.