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Re-branded, ObamaCare’s Medicaid expansion still wrong for Oklahoma

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A top priority for OCPA Impact has been for Oklahoma to hold firm on not implementing the optional expansion of Medicaid prescribed by the Affordable Care Act (“ObamaCare”).

To her credit, Gov. Mary Fallin has maintained Oklahoma will not adopt Medicaid expansion (link).

As pointed out by the Oklahoma Council of Public Affairs (link), Medicaid expansion would cost Oklahoma taxpayers hundreds of millions in additional dollars, as thousands of able-bodied, childless adults with income under 133% of the federal poverty level would be added to this federal entitlement.

Unlike most federal entitlements, Medicaid, while funded in part by the federal government, is primarily administered by state governments.

A recent piece in the Wall Street Journal (link) is a stark reminder that states that have accepted the ACA’s Medicaid expansion to increase enrollments have seen billions of dollars in unanticipated cost overruns.

Now, state government bureaucrats in Oklahoma want to use the current $1.3 billion state government budget shortfall as an excuse to squeeze in a re-branded version of the ACA’s Medicaid expansion (link).

The Oklahoma Health Care Authority, the state’s Medicaid agency, is pushing what it calls its “Medicaid Rebalancing” plan. A proposed 150% tax increase on cigarettes (link), which OCPA Impact opposes (link), is intended to fund the plan.

In a recent Journal Record column (link), OCPA’s Jonathan Small stated that the OHCA’s “Rebalancing” plan is, in fact, ObamaCare’s Medicaid expansion:

“With this attempt, OHCA bureaucrats have tried to box policymakers in by using a set of public relations tactics. First, the OHCA warned the Medicaid program may end. Then, the OHCA declared Medicaid (a taxpayer-funded entitlement program) the largest health insurer in the state. Then, the OHCA warned of cuts to the program, by way of provider cuts of 25 percent. Of course, the media ran with that story, stoking frenzy.”


“Nearly 27 percent of Oklahomans were enrolled in the Medicaid program during the most recent fiscal year according to the OHCA. If they get their way with their plan, then nearly 33 percent of Oklahomans will have their health care paid for nearly in full by government. This wouldn’t even take into account Medicare.

“Without the ACA Medicaid expansion, Oklahoma’s spending on Medicaid has grown largely because of the number of people on the program and previous expansions proffered by OHCA.

“Now, to swindle policymakers into a proposal that will incentivize people to decrease work and drop private health care coverage to gain subsidies, OHCA bureaucrats say their plan should be tried because they will release some currently on the Medicaid program to the treacherous, federally funded Obamacare exchange.


“Expanding government health care or welfare programs is bad policy and short-sighted whether oil is $100 a barrel or $30 a barrel. This is just a planted and dangerous distraction from lawmakers prioritizing spending in a tough budget year and providing the pay raise for teachers that they should by the end of this legislative session.”

Still, serious concerns exist about possible closures for health facilities located outside Oklahoma’s metro areas.

Unfortunately, the response from state bureaucrats has been to propose increasing the number of Oklahomans dependent on government for their health care and increasing our state’s dependency on federal dollars.

The OHCA’s “Rebalancing” plan is not intended to merely maintain Oklahoma’s current Medicaid levels. Rather, it would increase by at least 175,000 the number of Oklahomans enrolled in government-funded health care.

Thankfully, other routes are available. OCPA Impact has already helped successfully promote reforms, proven elsewhere — including in Florida and Louisiana — to reform Medicaid in Oklahoma. The goal should be to bring down the cost curve for taxpayers and increase sustainability without reducing quality of service for people eligible for the program.

OCPA Impact’s 2015 legislative scorecard (link) featured House Bill 1566, which Gov. Fallin signed into law to begin these reforms in Oklahoma. But the OHCA has been slow to implement the measure.

An additional option would be for Oklahoma lawmakers to use a portion of the investment earnings from the Tobacco Settlement Endowment Trust (TSET) to provide stopgap funding for health facilities outside the metro areas that are truly in need in Oklahoma’s current economic climate.

OCPA Impact will continue working to help keep ObamaCare’s costly Medicaid expansion out of Oklahoma.