Total state spending on health services (mostly Medicaid) has grown from $3.14 billion in fiscal 2005 to $5.436 billion in 2012 — an increase of 72.9 percent. According to the Oklahoma Health Care Authority, more than 1 million Oklahomans were enrolled in Medicaid in 2012 and approximately 393,100 in 2000. Medicaid covers 64 percent of the births in Oklahoma and covered 72.9 percent of Oklahoma's children younger than age 5 at some point in fiscal 2012. According to the authority, while the rate of federal reimbursements for Medicaid has declined six percentage points, all other revenue spent by Oklahoma on Medicaid has skyrocketed from $585 million in fiscal 2001 to over $1.8 billion (or 217 percent) in 2012!
The bait of “free” federal money has enticed state agencies to create and expand programs, which has significantly increased state spending to match federal money. Citizens and taxpayers should be encouraged that the governor's secretary of finance and revenue and chief budget negotiator, Preston Doerflinger, wants to see the state approach spending based on both performance- and priority-based budgeting. Equally encouraging, lawmakers are turning their attention to total state spending with the creation of House and Senate committees to review nonappropriated spending.
The Comprehensive Annual Financial Report shows there is much work left to do to focus government spending on core functions.
Small is fiscal policy director at the Oklahoma Council of Public Affairs (www.ocpathink.org).