Arizona Gov. Jan Brewer is now the third Republican governor to agree to the expansion of Medicaid in her state under the Affordable Care Act, despite understandable pressure from my fellow Republicans to have nothing to do with Obamacare. Brewer, like me, is no fan of President Obama or his policies. But Brewer, like me, knows that something must be done.
Up to 200,000 Oklahomans who make between $6,996 and $23,050 (100 percent of the federal poverty level) make too much to qualify for Medicaid and not enough to buy insurance. By declining the expansion, these Oklahomans can't gain access to health insurance, which means we pay for them through tax dollars every time I see them in my emergency room in Delaware County.
I respect Gov. Mary Fallin's decision not to participate in expansion of Medicaid in Oklahoma, but I believe this state should proceed toward a path of conservative, common-sense reform of the Medicaid system to make health care available for our poorest neighbors. Oklahoma can still accept the dollars in a responsible way for three reasons.
First, the Affordable Care Act is now an unavoidable reality; states would be worse off turning down the federal dollars due to the uncontested problem that all states face with access for the working poor. My colleagues and I in the Legislature need to think in terms of how to solve this issue, not how to stop it.
States that don't accept Medicaid funding are allowing other states to claim those federal dollars and create jobs that otherwise would be created at home. Brewer estimates that Medicaid expansion would inject $2 billion into the Arizona economy and bring the state an additional $7.9 billion in federal funds over four years to restore and expand the state's health care insurance program. Brewer will scale back enrollment if the terms of the deal change by the feds. I agree with Fallin that we can't commit ourselves to unknown future costs.
Finally, Brewer's decision is about economics. She understands that rejecting this expansion would destroy Arizona's hospital system. By agreeing to expand, Arizona would protect rural and safety-net hospitals from being pushed to the brink as they care for the poor and uninsured. With this move, Arizona will secure a federal revenue system to cover the costs of the uninsured who already access the health care system. The Oklahoma Hospital Association has been a leader in making some of these same arguments.
The Arizona legislature will still need to approve the expansion, but Brewer's leadership and bold stance should be applauded. I applaud Fallin for seeking other ways to address health care access, but I encourage her to reconsider Medicaid expansion.
Cox, R-Grove, represents District 5 in the Oklahoma House. He's an emergency room physician at Integris Grove General Hospital.