Medicaid expansion is unaffordable

In like manner, I don’t recall Gov. Mary Fallin receiving open records requests from curious journalists when taxes were hiked in 2011 to prop up LBJ’s Medicaid program in Oklahoma. It was only when she decided in 2012 not to expand Medicaid that the watchdogs started barking.

In any case, Gov. Fallin should be applauded for saying, “No thanks,” to the Obamacare Medicaid expansion. It took some political courage — many of the crony capitalists who supported Obamacare and its Medicaid expansion are significant GOP players — but it was the right decision. Quite simply, it’s a bad idea to borrow money from China in order to expand a dysfunctional, fraud-ridden welfare program that is almost certainly the worst health plan in America.

Especially when there are competing demands. “At long last,” wrote George Mason University law professor Michael S. Greve, “the entitlement state has begun to eat its own. The biggest federally funded program (Medicaid) is competing directly with the next-biggest set of programs (education). State politicians are now squeezed between the two most voracious (and unionized) constituencies in American politics: the education blob, and the health care/ AARP/provider complex.”

As my colleague, Jonathan Small, pointed out on this commentary page, Medicaid expansion would have crowded out spending on education, public safety, roads and bridges and other government services.

It also would have made it more difficult to reduce the state income tax, a project that has taken on new urgency now that (a) most Oklahomans’ federal taxes are going up this year, and (b) Oklahoma is starting to become an income-tax sandwich. Texas has no income tax, of course, and now Kansas’ top rate of 4.9 percent (and zero for nearly 200,000 small businesses) is lower than Oklahoma’s.

Incoming House Speaker T.W. Shannon rightly says the state of Oklahoma is already “addicted to federal spending.” This is not sustainable. Uncle Sugar is broke.

Indeed, odds are we’re now “at the twilight of the liberal welfare state,” wrote Charles Kesler, editor of the Claremont Review of Books. “As it sinks, a new, more conservative system will likely rise.” As conservative U.S. Sen. Tom Coburn put it, “sooner rather than later, the other side will have to accept reforms that are a lot closer to our principles than theirs.” Math is a pitiless taskmaster.

Now is no time to be expanding medical welfare. Indeed, if enough states refuse to expand Medicaid and refuse to build state insurance exchanges, Prof. Greve said, Obamacare may crash and burn before the end of Mr. Obama’s second term.

“State opposition is how the system is supposed to work,” he said. “The Madisonian precept gains special force and constitutional dignity in the context of federal programs that require, or rather imperiously demand, the states’ active cooperation.”

Oklahomans, God bless ’em, are in no mood to cooperate.

Dutcher is vice president for policy at the Oklahoma Council of Public Affairs, a free-market think tank based in OKC.

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