Coburn, a physician who has treated Medicaid patients and is a leading critic of the health care law, said Oklahomans would still be picking up part of the costs of the expansion in the early years since they are also federal taxpayers. The expansion is expected to cost $1 trillion over a decade, he said. Moreover, he said, budget pressures could force the federal government to reduce the share it is promising.
Accepting the federal government's deal would also give Washington more control over the state program, Coburn told Fallin, at a time when states should be given more flexibility.
The expansion also could shift people now on private insurance to the government program, Coburn warned, and ultimately lead doctors to quit seeing more Medicaid patients because of low reimbursement rates.
Research has shown Medicaid patients experience “lower health outcomes” than those on private health insurance, Coburn wrote.
Expanding SoonerCare to the new federal guidelines would make about 200,000 more adult Oklahomans eligible for the program, state health care authority officials have said. If the state were to expand eligibility, single adults making up to $15,415 would qualify, and a family of three would qualify with a household income at or below $26,344.