The health care reform bill approved by the State House last month could cost the state more than $128 million per year by its third year of implementation, according to estimates from a state health authority.

The Oklahoma Health Care Authority estimates the raised costs would be due in part to the bill’s mandatory Medicaid coverage. The coverage would add more than 318,000 Oklahomans to the program, expanding it by about 40 percent, Nico Gomez, the authority’s deputy chief executive officer, stated in a letter to Congresswoman Mary Fallin, R-Okla.

The House bill mandates Medicaid coverage for households that fall 150 percent below the poverty level, while the Senate bill mandates those 133 percent below the line, according to the letter. Medicaid covers primarily pregnant women and children in the state.

Michael Givel, OU political science professor, stated in an e-mail that 18 to 20 percent of Oklahomans are not currently covered under health insurance.

He said despite state cost increases, it would be a good thing if more people were receiving low-cost, universal health care.

“This assumes, of course, that these folks can afford the health care including potential increases in premiums, deductibles, co-pays and no reduction of services,” he said.

But there is no clear consensus that more poor people would participate, Givel said.

“They already are eligible under the current program and yet a number do not opt for public coverage for a variety of reasons,” he said.

Givel said there is also a bill up for debate in the Senate that would pay for the expansion of Medicaid with a tax on more expensive plans, while the House version would tax richer people to pay for the program.

State costs in Oklahoma will also increase due to a regular state matching rate for everyone below 150 percent of the poverty level, Gomez stated in the letter. He said the federal government assumes these people should already be in the state’s Medicaid program, but they are not as a result of not applying or completing their eligibility paperwork.

Gomez said while the bill envisions an enhanced federal match to cover the uninsured, it does not provide full federal funding.

“We cannot identify any mention of how administrative costs will be covered for the states as their Medicaid programs grow and thus have to assume that additional administrative expenses will be paid for under the current 50-50 match rate between the federal government and the states,” Gomez said.

Givel said neither the House nor the Senate versions of the bill provide controls on the private health industry to raise premiums, co-pays or reduce health services. He said the full financial impact to the state for either version of the bill is not yet known.

“While the parameters of the health model with an emphasis on expanding the customer base of private health companies while expanding coverage has become quite clear, the final details of the legislation between the House and Senate are still being negotiated,” Givel said.