In their words
Two sides to the question of expanding Medicaid in Oklahoma are presented
Excerpts of comments by Gov. Mary Fallin to Oklahoma Watch:
Oklahoma has a long tradition of investing in the health needs of our citizens. In Fiscal Year 2013 alone, the state spent $2 billion on Health and Human Services, supporting programs like Medicaid, Medicare, health clinics, mental health treatment and other health initiatives. Together that spending accounted for almost one third of our total state budget. As governor, supporting our health care and mental health programs is a priority of mine, which is why I will propose a substantial increase in funding to health-related initiatives in my next executive budget.
In the last year, it has become clear that many of our health improvement programs are working. The state has thankfully moved from 49th to 43rd in health rankings. While we still have much work to do, our focus on improving the overall health of our citizens and our financial commitment to health related services is moving the state in the right direction.
Much of this progress can also be attributed to the many Oklahomans who choose to work in the fields of health care or mental health services. One of these individuals is my aunt Dorthea Copeland, a wonderful lady who has spent much of her career dedicated to helping other Oklahomans. We are blessed to have many caring, compassionate and professional individuals like her working hard to help their neighbors.
While all of us would like to do more to help low-income Oklahomans get better access to affordable health care, the way President Obama has proposed to do so — through a massive expansion of Medicaid — is unaffordable and unworkable. The state of Oklahoma has rejected this plan for three reasons:
First, it is unaffordable for the state. According to a report from the Kaiser Commission on Medicaid and the Uninsured, the proposed expansion of Medicaid would result in a $689 million increase in state Medicaid costs between 2013 and 2022. Expanding Medicaid as proposed by the president would mean that a huge sum of money would be diverted from other priorities, like education and public safety, as well as existing health care programs.
Second, President Obama's plan is unaffordable for the country at a time when we are already experiencing a long-term spending crisis. The same Kaiser Commission report shows Medicaid expansion would cost the federal government $800 billion nationally. This comes at a time when it is universally acknowledged that Washington must make large cuts in government spending.
Finally, the Medicaid expansion offers no real reform to a flawed and inefficient system. Expansion should be tied to more flexible policies that reduce waste and fraud.
Moving forward, my administration will continue to support an “Oklahoma Plan” that focuses on improving the health of our citizens, lowering the frequency of preventable illnesses like diabetes and heart disease, and improving access to quality and affordable health care.
Excerpts of article by David Blatt, director of Oklahoma Policy Institute:
The Governor's claim (in November) that extending Medicaid would cost the state up to $475 million over seven years (2014 to 2020) is greatly exaggerated and misleading.
It includes costs the state will incur even if it doesn't expand Medicaid. Over 60 percent of the total cost cited by the governor is attributable to people who can already get Medicaid but are not enrolled. This includes some 45,000 children and 15,000 adults. Since Oklahoma will be on the hook for this population whether we expand Medicaid or not, their cost is not properly attributable to an expansion.
It is based on unrealistic participation assumptions. The Governor assumes 100 percent participation of every individual who is eligible for Medicaid — both the newly eligible and those currently eligible and not enrolled. This is contrary to all prior experiences with participation in public programs.
The Oklahoma Health Care Authority projects that the total state cost for newly eligible Oklahomans from 2014 to 2020 will range from $120 million, if 57 percent of those eligible participate, to $158 million, if 75 percent participate. At an average annual cost of $17.1 to $22.5 million, this is equivalent to less than 0.5 percent of current state appropriations.
It ignores savings to the state budget. The state currently spends close to $50 million annually providing health care services to uninsured adults through the Department of Mental Health and Substance Abuse Services, Corrections Department and Health Department. Expanding Medicaid would transfer 90 to 100 percent of the cost of services for newly insured adults from the state budget to the federal government.
It ignores state revenues that will be generated from increased health care spending. Expanding Medicaid would bring hundreds of millions of additional federal dollars each year to Oklahoma that will be spent on health care. This spending will generate additional jobs, which in turn generates additional tax revenues. State tax collections will jump $29.8 million in 2014, assuming that 57 percent of those newly eligible for Medicaid join, according to an OSU estimate.
Bottom line: If we set aside the population that is already eligible for Medicaid, use realistic participation assumptions, and consider offsetting savings and new revenues, the state will be looking at very modest spending increases by expanding Medicaid and could enjoy net savings. Instead of being a deal we can't afford, Medicaid expansion is a deal we can't afford to pass up.