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Medicaid expansion is affordable, and vital


Kate Richey January 23rd, 2013

For nearly 50 years, Medicaid has provided basic medical care to the poorest and most vulnerable Oklahomans. While Medicaid is the state’s primary safety net health care provider, many of the state’s poor are not currently eligible. The vast majority (93 percent) of those covered now under SoonerCare/Medicaid are children, seniors, disabled adults and pregnant women.

Under the Affordable Care Act’s Medicaid expansion, the federal government will pay the lion’s share of the cost for Oklahoma to extend SoonerCare coverage to most uninsured low-income adults. This would provide coverage to about 150,000 residents living near the poverty level. Expanding Medicaid would cut Oklahoma County’s uninsured population nearly in half, with more than 56,000 becoming newly eligible for SoonerCare in 2014.

Unfortunately, Gov. Mary Fallin announced recently that Oklahoma would turn down federal funds to expand SoonerCare. Her statement explained that “such an expansion would be unaffordable” and ignores the “out-of-control spending of the federal government.”

We know we’ve staked out the moral low ground when cutting spending on the backs of the working-poor is celebrated as “responsible.”

Uninsured Oklahomans have been dealt a serious blow, and their physical and financial health is sure to suffer.

Most of the low-income uninsured want health insurance and have tried to get it, but their employer doesn’t offer coverage and/or they don’t earn enough to afford a private plan. Many of us fortunate enough to have coverage know friends or family who have to go without. Even if you don’t know someone personally, the server who brought your lunch or the mechanic who changed your oil are likely among the ranks of the uninsured.

Ironically, rejecting the Medicaid expansion doesn’t actually reduce federal or state spending on health care. The governor has opted out of the low-cost comprehensive health care provided by a Medicaid plan and opted in to the most expensive health care plan there is: skyhigh urgent and emergency care for the uninsured, for which Oklahoma taxpayers will continue to pay through the nose.

Medicaid expansion comes at extremely minimal expense to the state, costing Oklahoma just half of 1 percent of total state appropriations annually. The federal income taxes paid by Oklahomans will still go toward the Medicaid expansion, whether we choose to participate or not. Except now, instead of funding our own health care and generating in-state economic activity, our income taxes will bolster healthcare systems in California, Connecticut, Minnesota, Illinois and every other state that ultimately expands (currently about half the states).

Whatever your politics, there is simply no arithmetical argument — in terms of what it ultimately costs taxpayers and providers — that favors ad hoc and uncompensated emergency care over Medicaid expansion.

Richey is a policy analyst at the Oklahoma Policy Institute, a Tulsa-based think tank. She specializes in health care, immigration and economic policy.


Opinions expressed on the commentary page, in letters to the editor and elsewhere in this newspaper are those of the author and do not necessarily reflect the opinions of ownership or management.

 
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