An Oklahoma state Senate committee rejected a measure that “would have repealed a 1987 law that prevents cities and towns from enacting tobacco use restrictions stricter than that of the state” by a 2-6 vote on Monday — drawing sharp rebukes from public health advocates who see the legislation’s failure as a political concession to Big Tobacco, and even drawing the ire of the state’s GOP Gov. Mary Fallin, who has called on lawmakers to pass legislation aimed at curbing Oklahoma’s smoking-related public health care costs.

“This is a victory for tobacco lobbyists and the tobacco industry,” said Alex Weintz, Fallin’s communications director. “It’s a defeat for the state of Oklahoma and anyone who cares about improving our health.”

As OKNews reports, the debate over SB 36 revealed a clear correlation between the state senators’ votes and the amount of money they received from the tobacco lobby:

The debate on the measure turned into a showdown between Sen. Frank Simpson, R-Ardmore, the only senator to sign a pledge to refuse all contributions, meals and gifts from the tobacco industry, and Sen. Rob Johnson, who is listed as the No. 1 recipient on a website that tracks legislators receiving money from tobacco lobbyists.

Johnson, R-Yukon, received about $11,295 in campaign contributions and gifts from those who were identified as tobacco lobbyists since 2006, according to the website tobaccomoney.com, which was started last year by Doug Matheny, the former director of tobacco prevention at the state Health Department. [...]

“From the tobacco companies themselves, I don’t think I’ve received that much comparatively to other interests,” he said. “It has absolutely nothing to do with it. I’ve taken max contributions from somebody and completely have been opposed to an idea they’ve had.”

Johnson and his fellow reform opponents implied that SB 36 would be a burden on businesses, since it would discourage Oklahoma residents from patronizing establishments that don’t allow smoking. But that logic completely ignores the very real — and very significant — costs of the state’s smoking epidemic. National smoking-related medical costs amount to $200 billion in preventable spending every year, and studies have confirmed that states making small investments in smoking cessation policies see massive economic returns. In Oklahoma specifically, where about 5,800 people die each year from smoking, every household pays an estimated $556 annually in state and federal taxes to cover smoking-caused medical costs.

Ultimately, the measure’s defeat is a reminder of the outsized influence that Big Tobacco continues to enjoy. Fallin has vowed to continue her fight to encourage anti-smoking efforts in Oklahoma, and will potentially call for a popular referendum on SB 36 — but if she does, the people of Oklahoma can expect a titanic statewide lobbying campaign by the tobacco industry.

Gov. Mary Fallin (R-OK)

Fallin’s aunt, 85-year-old Dorthea Copeland, runs a free health clinic in Pottawatomie County, an area of Oklahoma that has an 18 percent poverty rate and a 28 percent uninsurance rate. Copeland’s clinic provides care for the Oklahomans who fall into the coverage gap between earning too little to be able to purchase private insurance and earning too much to qualify for Medicaid assistance — the same group of people who stand to gain coverage under Obamacare’s expansion of the public program.

But since Copeland’s niece has refused to raise the Medicaid program’s eligibility level, the clinic is currently overloaded with low-income patients who don’t currently qualify for government assistance. As Oklahoma Watch reports, Copeland’s volunteer staff — who served over 850 patients last year — are now struggling to keep up with the increasing demand for health services:

On any given Thursday evening, about 20 people pitch in. But it’s not quite enough to keep up with rising demand. On this night, five people will be told they’ll need to wait at least a week to see a doctor.

“It’s getting worse all the time,” says Ty Johnson, who shows up every week to handle patient intake. She bustles about the crowded clinic with a clipboard, calling out names and handing out paperwork. “We’re getting more and more people.”

Not everyone makes the cut. To qualify, patients must be Pottawatomie County residents, must have no other form of insurance coverage and must fall below income caps that are considerably lower than those contained in the Obama expansion plan.

“There is just more need than we can handle,” says Stephanie Scrutchins, who determines eligibility.

Under Oklahoma’s current law, families can’t get Medicaid coverage unless they have dependent children and their annual income falls below $6,996 for a family of four — one of the lowest eligibility thresholds in the nation. The health law seeks to expand the program to include families of four earning up to $30,656 each year. But Fallin says it would be too costly to add additional low-income residents to her state’s Medicaid rolls, despite the fact that outside reports estimate expanding Medicaid would actually save Oklahoma nearly $48 million per year.

When Oklahoma Watch asked Copeland what she thought about her niece’s decision to reject the Medicaid expansion, she didn’t comment. “You know, I don’t get into politics,” she said. “I just run my little business here. Hopefully, we’ll do all that we can for the people that come in. Right now I’m looking at all the returns I’ve got for next Thursday night, wondering how in the world we’ll get them done.”